Provider Demographics
NPI:1164872701
Name:ADUNBARIN, ROSELINE IYABODE (DNP)
Entity Type:Individual
Prefix:
First Name:ROSELINE
Middle Name:IYABODE
Last Name:ADUNBARIN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7515 STENTON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-3710
Mailing Address - Country:US
Mailing Address - Phone:215-440-9547
Mailing Address - Fax:
Practice Address - Street 1:1401 WHITEHORSE MERCERVILLE RD STE 219
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3835
Practice Address - Country:US
Practice Address - Phone:609-581-5150
Practice Address - Fax:609-584-5144
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00730400363L00000X, 363LF0000X
PASP016235363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner