Provider Demographics
NPI:1114441102
Name:ODERANTI, JOSHUA D (DNP, APN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:D
Last Name:ODERANTI
Suffix:
Gender:M
Credentials:DNP, APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:J2 BRIER HILL CT
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3340
Mailing Address - Country:US
Mailing Address - Phone:732-390-7750
Mailing Address - Fax:732-390-7725
Practice Address - Street 1:34-36 PROGRESS ST STE B2
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1197
Practice Address - Country:US
Practice Address - Phone:908-757-9696
Practice Address - Fax:908-757-9721
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00748700363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1790396281OtherTITAN HEALTH GROUP NPI#