Provider Demographics
NPI:1821808346
Name:ONGAKI, MOAB OKARI (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:MOAB
Middle Name:OKARI
Last Name:ONGAKI
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 STATION DR APT 1205
Mailing Address - Street 2:
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-1870
Mailing Address - Country:US
Mailing Address - Phone:201-304-8591
Mailing Address - Fax:
Practice Address - Street 1:1200 STATION DR APT 1205
Practice Address - Street 2:
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001-1870
Practice Address - Country:US
Practice Address - Phone:201-304-8591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15248000363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health