Provider Demographics
NPI:1619740677
Name:OLOWOPOROKU, PATRICK AKINWUMI (APN, PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:AKINWUMI
Last Name:OLOWOPOROKU
Suffix:
Gender:M
Credentials:APN, PMHNP-BC
Other - Prefix:
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Mailing Address - Street 1:1124 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-1924
Mailing Address - Country:US
Mailing Address - Phone:917-873-2593
Mailing Address - Fax:
Practice Address - Street 1:40 UNION AVE STE 301
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-3290
Practice Address - Country:US
Practice Address - Phone:862-849-2618
Practice Address - Fax:848-900-8008
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14949800363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health