Basic Information
| Provider Information | |||||||||
| NPI: | 1477062347 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OYEM | ||||||||
| FirstName: | KINGSLEY | ||||||||
| MiddleName: | OGIGI | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | APN PMHNP-BC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | OYEM | ||||||||
| OtherFirstName: | KINGSLEY | ||||||||
| OtherMiddleName: | OGIGI | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MSN APN PMHNP-BC | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1131 ELKER RD | ||||||||
| Address2: | |||||||||
| City: | UNION | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070835006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3479127566 | ||||||||
| FaxNumber: | 6464908780 | ||||||||
| Practice Location | |||||||||
| Address1: | RWJBARNABAS HEALTH, JERSEY CITY MEDICAL CENTER | ||||||||
| Address2: | 355 GRAND STREET | ||||||||
| City: | JERSEY CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2019152000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2017 | ||||||||
| LastUpdateDate: | 10/26/2021 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 10/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 26NJ00764100 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.