Provider Demographics
NPI:1942817325
Name:ADEROHUNMU, ADEYEMI
Entity Type:Individual
Prefix:MR
First Name:ADEYEMI
Middle Name:
Last Name:ADEROHUNMU
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 1:84 RIVER ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-2826
Mailing Address - Country:US
Mailing Address - Phone:309-750-3695
Mailing Address - Fax:
Practice Address - Street 1:84 RIVER ST UNIT A
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-2826
Practice Address - Country:US
Practice Address - Phone:309-750-3695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist