Healthcare Provider Details

I. General information

NPI: 1568628550
Provider Name (Legal Business Name): ADEPEJU ENITAN CHRISTINA OREDERU REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ADEPEJU ENITAN CHRISTINA ODUFUNADE REGISTERED P NURSE

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 ROBIN ST
SCHENECTADY NY
12306-4826
US

IV. Provider business mailing address

7 ROBIN ST
SCHENECTADY NY
12306-4826
US

V. Phone/Fax

Practice location:
  • Phone: 518-730-2676
  • Fax:
Mailing address:
  • Phone: 518-709-4375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number560531-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number560531-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number560531-1
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number560531-1
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code101200000X
TaxonomyDrama Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: