Provider Demographics
NPI:1497339303
Name:ADAH, OMONUWA OSA (MD)
Entity type:Individual
Prefix:
First Name:OMONUWA
Middle Name:OSA
Last Name:ADAH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 MORRIS AVE STE D210
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-8037
Mailing Address - Country:US
Mailing Address - Phone:908-258-0220
Mailing Address - Fax:708-763-1471
Practice Address - Street 1:2333 MORRIS AVE STE D210
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-8037
Practice Address - Country:US
Practice Address - Phone:908-258-0220
Practice Address - Fax:708-763-1471
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA12261800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine