Individual
PATRICK OBINNA OLEDIMMAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
540 NORTH AVE, STE 3, UNION, NJ 07083-7149
(862) 368-5801
Mailing address
816 CALDWELL AVE, UNION, NJ 07083-6737
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00755000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NJ00755000
NURSE PRACTITIONER, MENTAL HEALTH.
NJ
05
—
26NJ00755000
—
NJ
Enumeration date
10/04/2017
Last updated
07/09/2019
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