Provider Demographics
NPI:1477081156
Name:ADIBE, RALEKE O (DO)
Entity Type:Individual
Prefix:DR
First Name:RALEKE
Middle Name:O
Last Name:ADIBE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 S WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:SOMERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08083-1737
Mailing Address - Country:US
Mailing Address - Phone:856-545-9620
Mailing Address - Fax:
Practice Address - Street 1:1 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:SOMERDALE
Practice Address - State:NJ
Practice Address - Zip Code:08083-1737
Practice Address - Country:US
Practice Address - Phone:856-545-9620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-25
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJP18-00908207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine