Provider Demographics
NPI:1194880583
Name:OJI, OMOBOLA A (MD)
Entity type:Individual
Prefix:DR
First Name:OMOBOLA
Middle Name:A
Last Name:OJI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CRAIG PL
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-4777
Mailing Address - Country:US
Mailing Address - Phone:908-791-9993
Mailing Address - Fax:
Practice Address - Street 1:25 CRAIG PL
Practice Address - Street 2:
Practice Address - City:NORTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-4777
Practice Address - Country:US
Practice Address - Phone:908-791-9993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA068918207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG97916Medicare UPIN
NJ1962567354Medicare PIN
NJ087533Medicare UPIN
NJ028005Medicare PIN
NJ1194880583Medicare PIN