Provider Demographics
NPI:1235825894
Name:ADENAIKE, MUSAFAU OLADIRAN (PMHNP)
Entity Type:Individual
Prefix:
First Name:MUSAFAU
Middle Name:OLADIRAN
Last Name:ADENAIKE
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07107-4197
Mailing Address - Country:US
Mailing Address - Phone:973-517-0123
Mailing Address - Fax:
Practice Address - Street 1:107 S 12TH ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-4197
Practice Address - Country:US
Practice Address - Phone:973-517-0123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01469400363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health