Provider Demographics
NPI:1285209536
Name:ADEYEMO, ADEOLUWA (APN)
Entity type:Individual
Prefix:
First Name:ADEOLUWA
Middle Name:
Last Name:ADEYEMO
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1223
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-0823
Mailing Address - Country:US
Mailing Address - Phone:732-986-1971
Mailing Address - Fax:
Practice Address - Street 1:1517 DURHAM RD
Practice Address - Street 2:
Practice Address - City:PENNDEL
Practice Address - State:PA
Practice Address - Zip Code:19047-5707
Practice Address - Country:US
Practice Address - Phone:732-986-1971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2023-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ011474002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry