Provider Demographics
NPI:1932530482
Name:ALALADE, ADEDAYO COMFORT (CRNA)
Entity Type:Individual
Prefix:
First Name:ADEDAYO
Middle Name:COMFORT
Last Name:ALALADE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ADEDAYO
Other - Middle Name:COMFORT
Other - Last Name:ADEMOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:46 YOCUM DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-7710
Mailing Address - Country:US
Mailing Address - Phone:301-613-0370
Mailing Address - Fax:
Practice Address - Street 1:6903 OLD HARFORD RD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-7644
Practice Address - Country:US
Practice Address - Phone:301-613-0370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-10
Last Update Date:2015-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD100785367500000X
PARN655898163W00000X
MDR178057163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse