Provider Demographics
NPI:1508405382
Name:AROWOLO, ADEBAYO M (PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:ADEBAYO
Middle Name:M
Last Name:AROWOLO
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 BAYVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-1050
Mailing Address - Country:US
Mailing Address - Phone:201-887-0029
Mailing Address - Fax:
Practice Address - Street 1:245 BAYVILLE AVE
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08721-1050
Practice Address - Country:US
Practice Address - Phone:201-887-0029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01003500363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health