Provider Demographics
NPI:1669826053
Name:OLOYEDE, TITILOLA OLAYEMI (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:TITILOLA
Middle Name:OLAYEMI
Last Name:OLOYEDE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MONTGOMERY ST FL 14
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3829
Mailing Address - Country:US
Mailing Address - Phone:201-432-2133
Mailing Address - Fax:
Practice Address - Street 1:30 MONTGOMERY ST FL 14
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3829
Practice Address - Country:US
Practice Address - Phone:201-432-2133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-21
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00623400282N00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No282N00000XHospitalsGeneral Acute Care Hospital