Healthcare Provider Details

I. General information

NPI: 1164974762
Provider Name (Legal Business Name): ADEOLA GABRIEL OBAYANJU DNP, APN, AGPNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ADEOLA OBAYANJU DNP, APN, AGPCNP-BC

II. Dates (important events)

Enumeration Date: 10/30/2016
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 MORRISTOWN RD
BASKING RIDGE NJ
07920-1654
US

IV. Provider business mailing address

333 N SUMMIT ST FL 15
TOLEDO OH
43604-2615
US

V. Phone/Fax

Practice location:
  • Phone: 973-348-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN05080
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number26NJ01268100
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR12639700
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN80391
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: