Organization
ICONICHEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLASUMBO JOSEPH OLADERU NURSE PRACTITIONER (CHIEF OPERATING OFFICER)
(609) 321-0233
Entity
Organization
Contact information
Practice address
1901 N OLDEN AVENUE EXT STE 11A, EWING, NJ 08618-2100
(609) 583-4970
(609) 323-7385
Mailing address
1901 N OLDEN AVENUE EXT STE 11A, EWING, NJ 08618-2100
(609) 583-4970
(609) 323-7385
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/19/2020
Last updated
01/28/2026
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