Provider Demographics
NPI:1114782919
Name:BAKARE, ADEBIMPE ABIODUN
Entity Type:Individual
Prefix:
First Name:ADEBIMPE
Middle Name:ABIODUN
Last Name:BAKARE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 S 18TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103
Mailing Address - Country:US
Mailing Address - Phone:862-270-9532
Mailing Address - Fax:
Practice Address - Street 1:729 S 18TH STREET
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103
Practice Address - Country:US
Practice Address - Phone:862-270-9532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor