1902586043 NPI number — MRS. OLUWASEYI OLUWASEUN EFFRAIM MPH MSN CRNP PMHNP

Table of content: MRS. OLUWASEYI OLUWASEUN EFFRAIM MPH MSN CRNP PMHNP (NPI 1902586043)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902586043 NPI number — MRS. OLUWASEYI OLUWASEUN EFFRAIM MPH MSN CRNP PMHNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EFFRAIM
Provider First Name:
OLUWASEYI
Provider Middle Name:
OLUWASEUN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MPH MSN CRNP PMHNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902586043
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/17/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 GERMANTOWN PIKE STE B1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLYMOUTH MEETING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19462-2482
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7516 CITY AVE STE 7&8
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19151-2102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-383-2710
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/24/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  SP027883 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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