Provider Demographics
NPI:1952128274
Name:OLAODE, RACHAEL OLUBUNMI (PMHNP)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:OLUBUNMI
Last Name:OLAODE
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 ESSEX AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-1535
Mailing Address - Country:US
Mailing Address - Phone:862-686-0231
Mailing Address - Fax:
Practice Address - Street 1:44 ESSEX AVE STE 2
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-1535
Practice Address - Country:US
Practice Address - Phone:908-557-9015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15157700363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health