Provider Demographics
NPI:1538299615
Name:OBLEADA, CLARITA N (MD)
Entity Type:Individual
Prefix:DR
First Name:CLARITA
Middle Name:N
Last Name:OBLEADA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 ROUTE 22 EAST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2405
Mailing Address - Country:US
Mailing Address - Phone:908-722-1881
Mailing Address - Fax:908-704-0215
Practice Address - Street 1:540 US HIGHWAY 22 EAST
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2405
Practice Address - Country:US
Practice Address - Phone:908-722-1881
Practice Address - Fax:908-704-0215
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA607282084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7669607Medicaid
F93259Medicare UPIN
NJ7669607Medicaid