Provider Demographics
NPI:1245844885
Name:ADELEKE-ASALU, BULYAMIN ADESOJI (ADM)
Entity type:Individual
Prefix:DR
First Name:BULYAMIN
Middle Name:ADESOJI
Last Name:ADELEKE-ASALU
Suffix:
Gender:M
Credentials:ADM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CLAYTON LN
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-1241
Mailing Address - Country:US
Mailing Address - Phone:267-945-1161
Mailing Address - Fax:
Practice Address - Street 1:9 CLAYTON LN
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-1241
Practice Address - Country:US
Practice Address - Phone:267-945-1161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA44033601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health