Provider Demographics
NPI:1821286436
Name:ADARAMOLA, MOJISOLA (MD)
Entity Type:Individual
Prefix:DR
First Name:MOJISOLA
Middle Name:
Last Name:ADARAMOLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MOJISOLA
Other - Middle Name:
Other - Last Name:ADARAMOLA-OJO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1140 BLOOMFIELD AVE STE 213
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-7126
Mailing Address - Country:US
Mailing Address - Phone:973-228-6302
Mailing Address - Fax:973-228-6302
Practice Address - Street 1:1140 BLOOMFIELD AVE STE 213
Practice Address - Street 2:
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-7126
Practice Address - Country:US
Practice Address - Phone:732-228-6302
Practice Address - Fax:718-860-1838
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241965208000000X
NJ25MA09315500208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0502855Medicaid
NY00665274Medicaid