Provider Demographics
NPI:1831499862
Name:ADEJARE, ADEKEMI LINDA (RDN)
Entity Type:Individual
Prefix:
First Name:ADEKEMI
Middle Name:LINDA
Last Name:ADEJARE
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 BRIDGETON PIKE
Mailing Address - Street 2:
Mailing Address - City:MANTUA
Mailing Address - State:NJ
Mailing Address - Zip Code:08051-1925
Mailing Address - Country:US
Mailing Address - Phone:856-625-6607
Mailing Address - Fax:856-358-0572
Practice Address - Street 1:501 FRONT ST
Practice Address - Street 2:
Practice Address - City:ELMER
Practice Address - State:NJ
Practice Address - Zip Code:08318-2101
Practice Address - Country:US
Practice Address - Phone:856-363-1796
Practice Address - Fax:856-358-0572
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ945345133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered