Provider Demographics
NPI:1588980957
Name:ADENIYI, TEMITAYO ADEYOJU (STNA)
Entity type:Individual
Prefix:MR
First Name:TEMITAYO
Middle Name:ADEYOJU
Last Name:ADENIYI
Suffix:
Gender:M
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4157 HIGHGATE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-6805
Mailing Address - Country:US
Mailing Address - Phone:614-772-1558
Mailing Address - Fax:
Practice Address - Street 1:4157 HIGHGATE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-6805
Practice Address - Country:US
Practice Address - Phone:614-772-1558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-10
Last Update Date:2010-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400896770409376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide