# OCCUMEDLY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750985719
- **Authorized official:** MS. VANESSA EZEMADU (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (609) 900-7883

## Contact information

- **Practice address:** 377 VALLEY RD UNIT 2594, CLIFTON, NJ 07013-1319
- **Practice address phone:** (609) 900-7883
- **Mailing address:** 20 ANDERSON AVE, WALLINGTON, NJ 07057-1015
- **Mailing address phone:** (609) 900-7883

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | — |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |
| 171WH0202X | Home Modifications Contractor | — | NULL | — |
| 171WH0202X | Home Modifications Contractor | — | — | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | NULL | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | — | — |
| 246W00000X | Cardiology Technician | — | NULL | — |
| 246W00000X | Cardiology Technician | — | — | — |
| 246Y00000X | Health Information Specialist/Technologist | — | NULL | — |
| 246Y00000X | Health Information Specialist/Technologist | — | — | — |
| 247000000X | Health Information Technician | — | NULL | — |
| 247000000X | Health Information Technician | — | — | — |
| 251B00000X | Case Management Agency | — | NULL | — |
| 293D00000X | Physiological Laboratory | — | NULL | — |
| 305S00000X | Point of Service | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | NULL | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/30/2020
- **Last updated:** 01/14/2022