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Individual

ISAAC O OMOLOYIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PMHNP-BC

Contact information

Practice address
401 HAMBURG TPKE, SUITE 302, WAYNE, NJ 07470-2154
(973) 790-9222
(973) 790-0671
Mailing address
401 HAMBURG TPKE, SUITE 302, WAYNE, NJ 07470-2154
(973) 790-9222
(973) 790-0671

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00661000
NJ

Other

Enumeration date
08/19/2016
Last updated
08/19/2016
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