Provider Demographics
NPI:1487521589
Name:ADEWOLE, SUNDAY J I
Entity type:Individual
Prefix:
First Name:SUNDAY
Middle Name:J
Last Name:ADEWOLE
Suffix:I
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 1:42 SALEM ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07106-1706
Mailing Address - Country:US
Mailing Address - Phone:929-272-9456
Mailing Address - Fax:
Practice Address - Street 1:42 SALEM ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07106-1706
Practice Address - Country:US
Practice Address - Phone:929-272-9456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY816936163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)