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General NPI Number Information
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NPI Number | 1790434272
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Entity Type | Organization
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Legal Business Name | CONSCIENTIAMD P.A
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 734 IRMA AVE
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City | ORLANDO
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State | FL
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Zip | 32803-3853
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Country | US
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Telephone | 407-305-3389
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Fax | 917-477-6852
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Provider Business Mailing Address
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Address Line | 86 FURMAN BLVD
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City | KEYPORT
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State | NJ
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Zip | 07735-6004
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Country | US
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Telephone | 973-444-5590
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Fax | 917-477-6852
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SIMBIAT OLADIRAN-ADIGHIJE
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Credential | PHD
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Telephone | 973-444-5590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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