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NPI Code Detail

MEDICARE: ABOSEDE CECILIA OJO AGNP

MEDICARE: ABOSEDE CECILIA OJO AGNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse Practitioner26NJ01414500NJ

General Provider Information

NPI Number : 1104523752
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABOSEDE CECILIA OJO AGNP
Provider Business Mailing Address
First Line : 305 GRANT AVE
Second Line :
City : PINE BEACH
State : NJ
Zip : 08741-1522
Country : US
Telephone Number : 732-600-9670
Fax Number :
Provider Business Practice Location Address
First Line : 75 OLD TOMS RIVER RD
Second Line :
City : BRICK
State : NJ
Zip : 08723-7800
Country : US
Telephone Number : 732-451-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2023
Last Update Date : 02/14/2023

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