Healthcare Provider Details

I. General information

NPI: 1932003266
Provider Name (Legal Business Name): OLUWATOSIN ADEYEMO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 HALE RD
BURLINGTON NJ
08016-3817
US

IV. Provider business mailing address

4 HALE RD
BURLINGTON NJ
08016-3817
US

V. Phone/Fax

Practice location:
  • Phone: 609-271-5482
  • Fax:
Mailing address:
  • Phone: 609-271-5482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number26NJ15677400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: