Provider Demographics
NPI:1598453136
Name:OSINBOYEJO, ADEOYE
Entity Type:Individual
Prefix:
First Name:ADEOYE
Middle Name:
Last Name:OSINBOYEJO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5614 DOUGHBOY LOOP
Mailing Address - Street 2:
Mailing Address - City:FORT DIX
Mailing Address - State:NJ
Mailing Address - Zip Code:08640-5429
Mailing Address - Country:US
Mailing Address - Phone:609-724-0008
Mailing Address - Fax:
Practice Address - Street 1:5614 DOUGHBOY LOOP
Practice Address - Street 2:
Practice Address - City:FORT DIX
Practice Address - State:NJ
Practice Address - Zip Code:08640-5429
Practice Address - Country:US
Practice Address - Phone:609-724-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians