Organization
GRACE MEDICAL CONSULT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADEWALE ADEFOWOJU MSN, APN, PMHNP-BC (MEDICAL DIRECTOR)
(908) 693-5036
Entity
Organization
Contact information
Practice address
40 UNION AVE, 3RD FL. STE 301, IRVINGTON, NJ 07111-3277
(973) 996-2170
Mailing address
40 UNION AVE, 3RD FL. STE 301, IRVINGTON, NJ 07111-3277
(973) 996-2170
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00196200
NJ
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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