Healthcare Provider Details

I. General information

NPI: 1326942798
Provider Name (Legal Business Name): ABIDEMI ADELE ALDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

904 SMITH ST
UNIONDALE NY
11553-3507
US

IV. Provider business mailing address

904 SMITH ST
UNIONDALE NY
11553-3507
US

V. Phone/Fax

Practice location:
  • Phone: 347-340-7672
  • Fax:
Mailing address:
  • Phone: 347-340-7672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: