Provider Demographics
NPI:1013466085
Name:RAJI, ADEDEJI
Entity type:Individual
Prefix:
First Name:ADEDEJI
Middle Name:
Last Name:RAJI
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 1:131 BAY 19TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-4607
Mailing Address - Country:US
Mailing Address - Phone:718-676-5327
Mailing Address - Fax:718-232-2359
Practice Address - Street 1:2075 WALLACE AVE APT 741
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-2460
Practice Address - Country:US
Practice Address - Phone:646-400-7842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool