Oyindamola Haulat Ikolaba
Individual provider Active NPI Pharmacist · Sayreville, NJ
NPI 1366059180 · NPPES record last updated Sep 25, 2020
Key facts
- NPI
- 1366059180
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 28RI04125500 (NJ)
- Practice address
- 11 Pero CT
Sayreville, NJ 08872-2117 - Phone
- (732) 347-4865
- NPI assigned
- Sep 25, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI04125500 | NJ | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI04125500 | NJ | Yes |
Addresses
Primary practice location
11 Pero CT
Sayreville, NJ 08872-2117
Mailing address
11 Pero CT
Sayreville, NJ 08872-2117
Phone (732) 347-4865
Other providers in Sayreville, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.