Bamgbose Pederson, Aderonke Olufunlola

Bamgbose Pederson, Aderonke Olufunlola is an individual health care provider with primary practice located at 55 Fruit St , Boston MA 02114-2621. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Bamgbose Pederson, Aderonke Olufunlola can be contacted via phone (617) 724-4100.

Contact Information

Primary practice address
55 Fruit St Boston MA 02114-2621
Phone: (617) 724-4100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 1396139655 Illinois
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X T290198 Massachusetts

Profile Details

NPI number 1396139655
LBN Legal business name Bamgbose Pederson, Aderonke Olufunlola
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2015
Last updated Jun 1st, 2023 - about last year

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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