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1720604986
MATHIAS OMON OLOGBOSELE
BURLINGTON, NJ
NPI
1720604986
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NJ 26NJ01039100)
Enumeration Date
2020-06-23
Last Update Date
2023-08-24
Business Address
MATHIAS OMON OLOGBOSELE
2 PASTERN TER
BURLINGTON, NJ 08016-4296
Phone number: 973-964-4720
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Mailing Address
MATHIAS OMON OLOGBOSELE
615 S 19TH ST
NEWARK, NJ 07103-1116
Phone number: 973-964-4720
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