Provider Demographics
NPI:1467723601
Name:OLUNUGA, OLUWATOSIN (PMHNP)
Entity type:Individual
Prefix:
First Name:OLUWATOSIN
Middle Name:
Last Name:OLUNUGA
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PLEASANT VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1144
Mailing Address - Country:US
Mailing Address - Phone:973-409-1406
Mailing Address - Fax:
Practice Address - Street 1:151 ROUTE 10 E STE 101
Practice Address - Street 2:
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1452
Practice Address - Country:US
Practice Address - Phone:973-296-2060
Practice Address - Fax:973-762-1808
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF404262-01363LP0808X
NJ26NJ01309600363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health