Provider Demographics
NPI:1457198640
Name:ADEOSHUN, TAOREED AYINLA
Entity type:Individual
Prefix:MR
First Name:TAOREED
Middle Name:AYINLA
Last Name:ADEOSHUN
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 1:6 BERNE DR
Mailing Address - Street 2:
Mailing Address - City:APALACHIN
Mailing Address - State:NY
Mailing Address - Zip Code:13732-4032
Mailing Address - Country:US
Mailing Address - Phone:347-665-5159
Mailing Address - Fax:
Practice Address - Street 1:6 BERNE DR
Practice Address - Street 2:
Practice Address - City:APALACHIN
Practice Address - State:NY
Practice Address - Zip Code:13732-4032
Practice Address - Country:US
Practice Address - Phone:347-665-5159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-13
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist