Provider Demographics
NPI:1932805496
Name:ADEDEJI, ANUOLUWAPO J
Entity Type:Individual
Prefix:
First Name:ANUOLUWAPO
Middle Name:J
Last Name:ADEDEJI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2194 HALSEY ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5110
Mailing Address - Country:US
Mailing Address - Phone:908-414-0652
Mailing Address - Fax:
Practice Address - Street 1:10 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3906
Practice Address - Country:US
Practice Address - Phone:732-744-0705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04288600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist