Organization
DIVINT HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIEN OGON (CREDENTIALING MANAGER)
(856) 398-0428
Entity
Organization
Contact information
Practice address
11 THOMASINE ST, EDISON, NJ 08817-5221
(347) 264-3957
Mailing address
11 THOMASINE ST, EDISON, NJ 08817-5221
(347) 264-3957
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/11/2026
Last updated
02/28/2026
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