Provider Demographics
NPI:1114521382
Name:SIYANBOLA, OLADEJI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:OLADEJI
Middle Name:
Last Name:SIYANBOLA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 KUGLER RD
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-1484
Mailing Address - Country:US
Mailing Address - Phone:610-495-1000
Mailing Address - Fax:610-495-8743
Practice Address - Street 1:5 KUGLER RD
Practice Address - Street 2:
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-1484
Practice Address - Country:US
Practice Address - Phone:610-495-1000
Practice Address - Fax:610-495-8743
Is Sole Proprietor?:No
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP454201183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist