MEDICARE: TEMILOLA ESTHER OMOTOSHO

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	SP036091	PA

General Provider Information

NPI Number	:	1861324592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEMILOLA ESTHER OMOTOSHO

Provider Business Mailing Address
First Line	:	207 CEDAR RD
Second Line	:
City	:	WALLINGFORD
State	:	PA
Zip	:	19086-7120
Country	:	US
Telephone Number	:	781-244-9193
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 W MAIN ST
Second Line	:
City	:	NORRISTOWN
State	:	PA
Zip	:	19401-4716
Country	:	US
Telephone Number	:	610-429-1591
Fax Number	:

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

Provider Enumeration Date	:	05/29/2026
Last Update Date	:	05/29/2026

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Directions to “ TEMILOLA ESTHER OMOTOSHO ” Practice Location

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