Provider Demographics
NPI:1003051285
Name:BABALOLA, ADEJOKE ABOLADE (DPM)
Entity Type:Individual
Prefix:DR
First Name:ADEJOKE
Middle Name:ABOLADE
Last Name:BABALOLA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:11546 MEXICO ST
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-2647
Mailing Address - Country:US
Mailing Address - Phone:718-470-2879
Mailing Address - Fax:718-470-2879
Practice Address - Street 1:15-01 POLLITT DR
Practice Address - Street 2:STE 8B
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2769
Practice Address - Country:US
Practice Address - Phone:917-291-6966
Practice Address - Fax:917-508-4815
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006283-1213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery