Provider Demographics
NPI:1952133605
Name:OJO, OLUWASANMI ABIODUN
Entity type:Individual
Prefix:
First Name:OLUWASANMI
Middle Name:ABIODUN
Last Name:OJO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 S WOODBURY TURNERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2889
Mailing Address - Country:US
Mailing Address - Phone:856-374-6100
Mailing Address - Fax:
Practice Address - Street 1:8 S WOODBURY TURNERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-2889
Practice Address - Country:US
Practice Address - Phone:856-374-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15062900363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health