Provider Demographics
NPI:1528226842
Name:ADERIBIGBE, ADEDAYO OLUBUNMI (MD)
Entity Type:Individual
Prefix:DR
First Name:ADEDAYO
Middle Name:OLUBUNMI
Last Name:ADERIBIGBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:629 AMBOY AVE
Mailing Address - Street 2:STE 109
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3579
Mailing Address - Country:US
Mailing Address - Phone:732-486-3365
Mailing Address - Fax:732-486-3367
Practice Address - Street 1:629 AMBOY AVE
Practice Address - Street 2:STE 109
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3579
Practice Address - Country:US
Practice Address - Phone:732-486-3365
Practice Address - Fax:732-486-3367
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08693900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA08693900OtherMEDICAL LICENSE