Provider Demographics
NPI:1861771800
Name:A.O.ADEYEMI CORPORATION
Entity type:Organization
Organization Name:A.O.ADEYEMI CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ABIODUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEYEMI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:917-405-8340
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:SHRUB OAK
Mailing Address - State:NY
Mailing Address - Zip Code:10588-0041
Mailing Address - Country:US
Mailing Address - Phone:917-405-8340
Mailing Address - Fax:914-302-2476
Practice Address - Street 1:3424 STONEY ST
Practice Address - Street 2:
Practice Address - City:MOHEGAN LAKE
Practice Address - State:NY
Practice Address - Zip Code:10547-1420
Practice Address - Country:US
Practice Address - Phone:917-405-8340
Practice Address - Fax:914-302-2476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency