Provider Demographics
NPI:1326273152
Name:OSHODI, ADEFOLAKE (MD)
Entity Type:Individual
Prefix:DR
First Name:ADEFOLAKE
Middle Name:
Last Name:OSHODI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FOLAKE
Other - Middle Name:
Other - Last Name:OSHODI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:531 50TH AVE
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5711
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:531 50TH AVE
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-5711
Practice Address - Country:US
Practice Address - Phone:646-308-1588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-22
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251761-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry