MEDICARE: GBEMISOLA AJEOLA ORE-OFE PMHNP-BC

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	26NJ15481200	NJ

General Provider Information

NPI Number	:	1336003094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GBEMISOLA AJEOLA ORE-OFE PMHNP-BC

Provider Business Mailing Address
First Line	:	1 KARL PL APT 7
Second Line	:
City	:	GARFIELD
State	:	NJ
Zip	:	07026-1622
Country	:	US
Telephone Number	:	646-201-6645
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 KARL PL APT 7
Second Line	:
City	:	GARFIELD
State	:	NJ
Zip	:	07026-1622
Country	:	US
Telephone Number	:	646-201-6645
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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