Olumuyiwa Ishola Fadahunsi

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1153 Bergen St
Newark, NJ 07112-2201

Phone

(862) 703-1375

NPI assigned

Feb 26, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pro Sahara LLC

  • Case Management Agency
  • Newark, NJ
  • NPI 1427894906
  NPD Authorized official

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1255197455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122201",
            "telephone_number": "862-703-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1153 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122201",
            "telephone_number": "862-703-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADAHUNSI",
        "first_name": "OLUMUYIWA",
        "middle_name": "ISHOLA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Chinyelu Ezepue, MD
• Judith Ezike, MD
• Ndidiamaka Ezuma, APN
• Mark Alan Faber, MD
• Laura J. Facas-Sullivan, LSW
• Olukunle Abiodun Fagbenro, DO
• Laura Rachel Fagen, MD
• Yessenia Carolina Faican-Vizhnay
• Nykeisha Faison, MASSAGE THERAPIST
• Faithful Home Health Care Inc. (Faithful Inc.)

• Counselor in Newark, NJ
• Providers in Newark, NJ by specialty
• Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.