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NPI Code Detail

MEDICARE: DR. ADEKUNLE ADEOTI MD

MEDICARE: DR. ADEKUNLE ADEOTI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMA61244NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740259639
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ADEKUNLE ADEOTI MD
Provider Business Mailing Address
First Line : 277 COIT ST
Second Line :
City : IRVINGTON
State : NJ
Zip : 07111-4105
Country : US
Telephone Number : 973-676-1920
Fax Number : 973-373-0510
Provider Business Practice Location Address
First Line : 277 COIT ST
Second Line :
City : IRVINGTON
State : NJ
Zip : 07111-4013
Country : US
Telephone Number : 973-676-1920
Fax Number : 973-373-0510
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 10/15/2011

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