Provider Demographics
NPI:1104575695
Name:CONSCIENTIAMD INC
Entity type:Organization
Organization Name:CONSCIENTIAMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMBIAT
Authorized Official - Middle Name:
Authorized Official - Last Name:OLADIRAN-ADIGHIJE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:281-305-0364
Mailing Address - Street 1:86 FURMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:KEYPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07735-6004
Mailing Address - Country:US
Mailing Address - Phone:973-444-5590
Mailing Address - Fax:
Practice Address - Street 1:5373 W ALABAMA ST STE 204
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-5923
Practice Address - Country:US
Practice Address - Phone:281-305-0364
Practice Address - Fax:917-477-6852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty