Provider Demographics
NPI:1407103534
Name:OLAYODE, ADEWALE (MD)
Entity Type:Individual
Prefix:
First Name:ADEWALE
Middle Name:
Last Name:OLAYODE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GUSTAVE L LEVY PL # 1264
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6504
Mailing Address - Country:US
Mailing Address - Phone:212-241-8867
Mailing Address - Fax:212-860-3669
Practice Address - Street 1:ONE GUSTAVE L. LEVY PLACE
Practice Address - Street 2:INSTITUTE OF CRITICAL CARE MEDICINE MOUNT SINAI NETWORK
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-8867
Practice Address - Fax:212-860-3669
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT51956207R00000X
NY3080732086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT51956OtherLICENSE