ICONICHEALTH LLC NPI 1972106292

NPI Information

NPI: 1972106292
Provider Name: ICONICHEALTH LLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
4 BOLEYN CT
EWING, NJ
ZIP 08628
Phone: (609) 321-0233
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ICONICHEALTH LLC is a psychiatric/mental health nurse practitioner in Ewing, NJ. ICONICHEALTH LLC NPI is 1972106292. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4 BOLEYN CT
EWING, NJ
ZIP 08628-231
Phone: (609) 321-0233

The provider's authorized official is Olasumbo Joseph Oladeru .
The authorized official title is Chief Operating Officer and has the following contact phone number (609) 321-0233.

The enumeration date for this NPI number is 11/19/2020 and was last updated on 11/19/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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