Provider Demographics
NPI:1700481314
Name:AROGUNDADE, NGOZI (NAVIGATOR)
Entity Type:Individual
Prefix:
First Name:NGOZI
Middle Name:
Last Name:AROGUNDADE
Suffix:
Gender:F
Credentials:NAVIGATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WINDSOR LN
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-2078
Mailing Address - Country:US
Mailing Address - Phone:973-493-6857
Mailing Address - Fax:973-521-8309
Practice Address - Street 1:37 KINGS RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-2500
Practice Address - Country:US
Practice Address - Phone:973-493-6857
Practice Address - Fax:973-521-8309
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00311300363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ272301379Medicaid