Healthcare Provider Details

I. General information

NPI: 1205912524
Provider Name (Legal Business Name): ADEBAYO ADEYINKA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2006
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 BROADWAY BROOKLYN NY
BROOKLYN NY
11206-5317
US

IV. Provider business mailing address

121 DEKALB AVE BROOKLYN
BROOKLYN NY
11201-5425
US

V. Phone/Fax

Practice location:
  • Phone: 718-983-8000
  • Fax:
Mailing address:
  • Phone: 718-250-6935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberM14405
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number60236698
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberN1514
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number01059643A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: