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General NPI Number Information
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NPI Number | 1902607542
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Entity Type | Organization
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Legal Business Name | STADD MED CONSULT
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 20 MAY TER
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City | VAUXHALL
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State | NJ
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Zip | 07088-1212
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Country | US
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Telephone | 908-494-6931
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Fax | 973-351-1288
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Provider Business Mailing Address
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Address Line | 20 MAY TER
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City | VAUXHALL
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State | NJ
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Zip | 07088-1212
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Country | US
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Telephone | 908-494-6931
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | OLUWASEUN ADEOTI
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Credential |
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Telephone | 908-296-7963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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