Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Excelsior Grace LLC

Organization Psychiatric/Mental Health Nurse Practitioner · NPI 1649149238

Excelsior Grace LLC is a Psychiatric/Mental Health Nurse Practitioner in Plainfield, New Jersey. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

959 W 4th St
Plainfield, NJ 07063-1372
Phone: (347) 302-1212
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X

Record details

NPI number1649149238
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Oluwabunmi Omotayo — Owner · (347) 302-1212
NPI enumeratedNovember 1, 2025
Last updated in NPPESNovember 4, 2025
Certification dateNovember 4, 2025
Mailing address959 W 4th St, Plainfield, NJ 07063-1372

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