Provider Demographics
NPI:1528358710
Name:ADELIYI, THERESA BOSEDE (MD, MPH)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:BOSEDE
Last Name:ADELIYI
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:200 BOWMAN DR STE E340
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9636
Practice Address - Country:US
Practice Address - Phone:856-247-7600
Practice Address - Fax:856-247-4452
Is Sole Proprietor?:No
Enumeration Date:2011-04-09
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC1-0011327207V00000X
NJ25MA10986200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology