Provider Demographics
NPI:1447508353
Name:FILANI, OLUWAGBENGA (RN)
Entity type:Individual
Prefix:
First Name:OLUWAGBENGA
Middle Name:
Last Name:FILANI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2329
Mailing Address - Country:US
Mailing Address - Phone:917-435-1042
Mailing Address - Fax:
Practice Address - Street 1:67 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2329
Practice Address - Country:US
Practice Address - Phone:917-435-1042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309236164W00000X
NJ26NR24797100163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse