Provider Demographics
NPI:1790988145
Name:OWOEYE, ADEREMI FOLASHADE
Entity Type:Individual
Prefix:MS
First Name:ADEREMI
Middle Name:FOLASHADE
Last Name:OWOEYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 SCENIC CT
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-1745
Mailing Address - Country:US
Mailing Address - Phone:908-684-0311
Mailing Address - Fax:908-684-0211
Practice Address - Street 1:50 SCENIC CT
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-1745
Practice Address - Country:US
Practice Address - Phone:908-684-0311
Practice Address - Fax:908-684-0211
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR12816800374T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel