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General NPI Number Information
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NPI Number | 1447658281
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Entity Type | Organization
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Legal Business Name | OLUKAYODE A OLADEJI MD LLC
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Dates
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Enumeration Date | 12/10/2014
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Last Update Date | 05/03/2015
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Provider Practice Location Address
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Address Line | 1 RACE TRACK RD SUITE A101
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-3870
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Country | US
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Telephone | 732-238-8090
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Fax | 732-238-8091
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Provider Business Mailing Address
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Address Line | PO BOX 696
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City | OLD BRIDGE
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State | NJ
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Zip | 08857-0696
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Country | US
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Telephone | 732-238-8090
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Fax | 732-238-8091
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Authorized Official
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Title or Position | OWNER
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Name | OLUKAYODE OLADEJI
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Credential | MD
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Telephone | 732-238-8090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 25MA06383900
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License Number State | NJ
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