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General NPI Number Information
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NPI Number | 1992521496
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Entity Type | Organization
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Legal Business Name | AMITY CENTER FOR MENTAL HEALTH
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Dates
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Enumeration Date | 11/29/2024
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Last Update Date | 11/29/2024
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Provider Practice Location Address
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Address Line | 936 STUYVESANT AVE STE 1
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City | UNION
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State | NJ
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Zip | 07083-6998
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Country | US
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Telephone | 973-580-1497
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Fax |
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Provider Business Mailing Address
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Address Line | 2 SUSAN CT
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City | FARMINGDALE
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State | NJ
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Zip | 07727-3761
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Country | US
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Telephone | 973-580-1497
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. DR.OLUFUNMILAYO O. ILORI
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Credential | DNP
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Telephone | 973-580-1497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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