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General NPI Number Information
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NPI Number | 1477829984
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Entity Type | Organization
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Legal Business Name | ADEJOKE BABALOLA, DPM, PC
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 184 E 70TH ST SUITEB1
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City | NEW YORK
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State | NY
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Zip | 10021-5154
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Country | US
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Telephone | 347-247-0206
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Fax |
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Provider Business Mailing Address
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Address Line | 11546 MEXICO ST
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City | SAINT ALBANS
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State | NY
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Zip | 11412-2647
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ADEJOKE BABALOLA
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Credential | D.P.M.
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Telephone | 718-470-2879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | 006283
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License Number State | NY
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