Provider Demographics
NPI:1093526709
Name:ADENIJI, KELANI OLADEPO
Entity type:Individual
Prefix:MR
First Name:KELANI
Middle Name:OLADEPO
Last Name:ADENIJI
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 1:68 LIVINGSTON AVE PH
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-2568
Mailing Address - Country:US
Mailing Address - Phone:917-385-7028
Mailing Address - Fax:
Practice Address - Street 1:1110 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-5370
Practice Address - Country:US
Practice Address - Phone:929-579-0025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY523118-01163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool