Excelsior Grace LLC
Nurse Practitioner, Psych/Mental Health in Plainfield, New Jersey
1649149238- Practice location
- 959 W 4TH St, Plainfield, NJ 07063-1372
- Phone
- 347-302-1212
- Fax
- —
- Last updated
- November 4, 2025
Excelsior Grace LLC is a healthcare organization based in Plainfield, NJ. Excelsior Grace LLC practices in Plainfield, NJ. The NPI Number for Excelsior Grace LLC is 1649149238. The current practice location address for Excelsior Grace LLC is 959 W 4TH St, Plainfield, NJ 07063-1372 and can be reached out via phone at 347-302-1212.
Provider Profile Details
- NPI Number
- 1649149238
- Provider Name
- Excelsior Grace LLC
- Provider Entity Type
- Organization
- Address
- 959 W 4TH St, Plainfield, NJ 07063-1372
- Phone Number
- 347-302-1212
- Primary Taxonomy
- Nurse Practitioner, Psych/Mental Health · 363LP0808X
- Organization Subpart
- No
- Authorized Official
- Oluwabunmi Omotayo, APN · Owner · 347-302-1212
- Provider Enumeration Date
- November 1, 2025
- Last Update Date
- November 4, 2025
- Certification Date
- November 4, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 959 W 4TH St
Plainfield, NJ 07063-1372 - City
- Plainfield
- State
- New Jersey
- Zip
- 07063-1372
- Phone Number
- 347-302-1212
Provider Business Mailing Address Details
- Address
- 959 W 4TH St
Plainfield, NJ 07063-1372 - City
- Plainfield
- State
- NJ
- Zip
- 07063-1372
- Phone Number
- 347-302-1212
License Information
- Taxonomy
- Nurse Practitioner, Psych/Mental Health · 363LP0808X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Excelsior Grace LLC?
The NPI number of Excelsior Grace LLC is 1649149238. It was assigned on November 1, 2025 and is currently active in the NPPES registry.
What is the specialty of Excelsior Grace LLC?
Excelsior Grace LLC is registered under the primary taxonomy Nurse Practitioner, Psych/Mental Health (code 363LP0808X).
Where does Excelsior Grace LLC practice?
The practice location is 959 W 4TH St, Plainfield, NJ 07063-1372. The office can be reached at 347-302-1212 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1649149238 directly on the NPPES registry website.