Provider Demographics
NPI:1881468759
Name:ADEPOJU, OLUMIDE (RN)
Entity type:Individual
Prefix:
First Name:OLUMIDE
Middle Name:
Last Name:ADEPOJU
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MSGR LYDON WAY APT 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02124-3082
Mailing Address - Country:US
Mailing Address - Phone:781-654-7574
Mailing Address - Fax:
Practice Address - Street 1:25 MSGR LYDON WAY APT 2
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02124-3082
Practice Address - Country:US
Practice Address - Phone:781-654-7574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health