Provider Demographics
NPI:1831976018
Name:CORECARE HEALTH LLC OF NEW JERSEY
Entity type:Organization
Organization Name:CORECARE HEALTH LLC OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:O
Authorized Official - Last Name:OLADIPO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP-BC
Authorized Official - Phone:733-710-5030
Mailing Address - Street 1:1346 HOW LN STE 201
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1725
Mailing Address - Country:US
Mailing Address - Phone:732-710-5030
Mailing Address - Fax:732-790-0325
Practice Address - Street 1:1346 HOW LN STE 201
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1725
Practice Address - Country:US
Practice Address - Phone:732-710-5030
Practice Address - Fax:732-790-0325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-12
Last Update Date:2024-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty