Provider Demographics
NPI:1558982439
Name:OMEGAHEALTH LLC
Entity Type:Organization
Organization Name:OMEGAHEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:MS
Authorized Official - First Name:MASOLANU
Authorized Official - Middle Name:B
Authorized Official - Last Name:LAWAL
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:862-368-4305
Mailing Address - Street 1:473 WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-2524
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:90 E HALSEY RD STE 333
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-3709
Practice Address - Country:US
Practice Address - Phone:863-368-4305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service