Individual provider · NPI-1

Mini Oommen, CPNP-PC

Nurse Practitioner, Pediatrics · Livingston, NJ

NPI number1508536590
StatusActive
Last updated in NPPESSep 20, 2021

Details

NPI
1508536590
Entity type
Individual (NPI-1)
Name
Mini Oommen
Credential
CPNP-PC
Sex
Female
Sole proprietor
Yes
Enumeration date
Sep 20, 2021
Certification date
Aug 11, 2021
Last updated
Sep 20, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, Pediatrics26NJ01179700NJYes

Other names

  • Mini Oommen (Professional Name)

Practice location

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Phone 973-322-5000

Mailing address

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Phone 973-322-5000

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