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NPI Code Detail

MEDICARE: DAMILOLA EUNICE FENWA

MEDICARE:   DAMILOLA EUNICE FENWA
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
1363LF0000XFamily Nurse Practitioner2026024500NJ

General Provider Information

NPI Number : 1225962293
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAMILOLA EUNICE FENWA
Provider Business Mailing Address
First Line : 501 THOREAU TER
Second Line :
City : UNION
State : NJ
Zip : 07083-7829
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 501 THOREAU TER
Second Line :
City : UNION
State : NJ
Zip : 07083-7829
Country : US
Telephone Number : 862-224-0308
Fax Number : 862-224-0308
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2026
Last Update Date : 06/12/2026

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Directions to “ DAMILOLA EUNICE FENWA ” Practice Location

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