Provider Demographics
NPI:1609548866
Name:ADARAMOLA, ADEPEJU I
Entity Type:Individual
Prefix:
First Name:ADEPEJU
Middle Name:I
Last Name:ADARAMOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 TIFFANY PL
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-1910
Mailing Address - Country:US
Mailing Address - Phone:908-659-8128
Mailing Address - Fax:
Practice Address - Street 1:9 TIFFANY PL
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-1910
Practice Address - Country:US
Practice Address - Phone:908-659-8128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care