Provider Demographics
NPI:1770477473
Name:ADEWUYI, TEMITOPE
Entity type:Individual
Prefix:DR
First Name:TEMITOPE
Middle Name:
Last Name:ADEWUYI
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 1:123-125 LINDSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07106-4902
Mailing Address - Country:US
Mailing Address - Phone:862-308-6443
Mailing Address - Fax:862-308-6443
Practice Address - Street 1:123-125 LINDSLEY AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07106-4902
Practice Address - Country:US
Practice Address - Phone:862-308-6443
Practice Address - Fax:862-308-6443
Is Sole Proprietor?:No
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ390200000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program