Provider Demographics
NPI:1225233877
Name:SOREMEKUN, OLANREWAJU ALADE (MD)
Entity type:Individual
Prefix:
First Name:OLANREWAJU
Middle Name:ALADE
Last Name:SOREMEKUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 SOUTH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6442
Mailing Address - Country:US
Mailing Address - Phone:973-695-4726
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:333 US HIGHWAY 46 STE 106
Practice Address - Street 2:
Practice Address - City:MOUNTAIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07046-1741
Practice Address - Country:US
Practice Address - Phone:973-939-6220
Practice Address - Fax:215-955-2526
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09765800207P00000X
MAL-228648207P00000X
PAMD439459207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0230065Medicaid
PA102476684 0002Medicaid
PA102476684 0003Medicaid
PA278188Medicare PIN