Sore Ouedraogo, Alimata

Sore Ouedraogo, Alimata is an individual health care provider with primary practice located at 176 Palisade Ave , Jersey City NJ 07306. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Sore Ouedraogo, Alimata can be contacted via phone (201) 795-8200.

Contact Information

Primary practice address
176 Palisade Ave Jersey City NJ 07306
Phone: (201) 795-8200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 26NJ01068900 New Jersey
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 26NJ01068900 New Jersey

Profile Details

NPI number 1639778301
LBN Legal business name Sore Ouedraogo, Alimata
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 22nd, 2020
Last updated Apr 3rd, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639778301 NPPES
New Jersey MEDICAID 0773093

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