Ayodeji, Adeola O

Ayodeji, Adeola O is an individual health care provider with primary practice located at 147 Lake Street , Newburgh NY 12550-5242. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Ayodeji, Adeola O can be contacted via phone (845) 563-8000.

Contact Information

Primary practice address
147 Lake Street Newburgh NY 12550-5242
Phone: (845) 563-8000
Fax: (845) 563-8096
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 001909 New York
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 241089 New York
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 241089-1 New York

Profile Details

NPI number 1689660201
LBN Legal business name Ayodeji, Adeola O
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated Sep 30th, 2016 - about 9 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 1689660201 NPPES
New York MEDICAID 02796367

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