Provider Demographics
NPI:1093917684
Name:OLABISI, ADEKEMI (PHARMD)
Entity Type:Individual
Prefix:
First Name:ADEKEMI
Middle Name:
Last Name:OLABISI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ADEKEMI
Other - Middle Name:
Other - Last Name:ADEKOJE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 COPLEY PL
Mailing Address - Street 2:SUITE 600
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-6502
Mailing Address - Country:US
Mailing Address - Phone:617-748-6031
Mailing Address - Fax:
Practice Address - Street 1:2 COPLEY PL
Practice Address - Street 2:SUITE 600
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-6502
Practice Address - Country:US
Practice Address - Phone:617-748-6031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0507651835P1200X
MAPH232606183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy