Provider Demographics
NPI:1942630611
Name:AYANGADE, TOLULOPE (MD)
Entity Type:Individual
Prefix:DR
First Name:TOLULOPE
Middle Name:
Last Name:AYANGADE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MAYFAIR GARDENS, CLOSE 8, PLOT 174
Mailing Address - Street 2:LEKKI EXPRESSWAY
Mailing Address - City:LAGOS
Mailing Address - State:LAGOS
Mailing Address - Zip Code:LAGOS
Mailing Address - Country:NG
Mailing Address - Phone:732-745-8600
Mailing Address - Fax:
Practice Address - Street 1:254 EASTON AVE
Practice Address - Street 2:ST PETERS UNIVERSITY HOSPITAL
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1766
Practice Address - Country:US
Practice Address - Phone:732-745-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0011427207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine