Omoloyin LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

OMOLOYIN LLC

Practice address

114 Canterbury LN
Morganville, NJ 07751-5200

Phone

(973) 978-0650

NPI assigned

Aug 14, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Isaac Olaniran OmoloyinNPI 1770038788

Title

Owner/ Apn

Phone

(973) 978-0650

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Isaac O Omoloyin, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Wayne, NJ
  • NPI 1770038788
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1053142687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 PRESTS MILL RD",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572740",
            "telephone_number": "973-978-0650",
            "fax_number": "973-642-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 CANTERBURY LN",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077515200",
            "telephone_number": "973-978-0650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "833 River St",
            "address_purpose": "LOCATION",
            "city": "Paterson",
            "state": "NJ",
            "postal_code": "075241318",
            "country_code": "US",
            "telephone_number": "973-978-0650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Broadway Fl 6",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071048000",
            "country_code": "US",
            "telephone_number": "973-978-0650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OMOLOYIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-14",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "OMOLOYIN",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_middle_name": "OLANIRAN",
        "authorized_official_title_or_position": "OWNER/ APN",
        "authorized_official_telephone_number": "973-978-0650"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Morganville, NJ
• Providers in Morganville, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.