Provider Demographics
NPI:1336466887
Name:ADEBAYO, EMMANUEL OLUFEMI (DPT)
Entity Type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:OLUFEMI
Last Name:ADEBAYO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1 FARM HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-8918
Mailing Address - Country:US
Mailing Address - Phone:914-843-4726
Mailing Address - Fax:845-694-6155
Practice Address - Street 1:6 LINCOLN PL
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-5203
Practice Address - Country:US
Practice Address - Phone:914-762-0972
Practice Address - Fax:914-762-0972
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015354-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist