Provider Demographics
NPI:1154683365
Name:ADESANYA, TEMILADE (RN)
Entity Type:Individual
Prefix:
First Name:TEMILADE
Middle Name:
Last Name:ADESANYA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 US HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2949
Mailing Address - Country:US
Mailing Address - Phone:844-722-1580
Mailing Address - Fax:
Practice Address - Street 1:1065 US HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2949
Practice Address - Country:US
Practice Address - Phone:844-722-1580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY609247163W00000X
NJ26NR13920900163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse