Provider Demographics
NPI:1699421537
Name:AJADI, AMINAT OMOLARA (RN)
Entity type:Individual
Prefix:
First Name:AMINAT
Middle Name:OMOLARA
Last Name:AJADI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51-57 BRENNER ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07108-1666
Mailing Address - Country:US
Mailing Address - Phone:973-220-2564
Mailing Address - Fax:
Practice Address - Street 1:132 EVERGREEN RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2484
Practice Address - Country:US
Practice Address - Phone:732-452-4142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR16033500163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse