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General NPI Number Information
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NPI Number | 1649204959
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Entity Type | Individual
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Provider Name | ADEOLA R UTHMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 10/29/2012
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Provider Practice Location Address
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Address Line | 225 PARKSIDE AVE
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City | BROOKLYN
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State | NY
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Zip | 11226-1361
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Country | US
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Telephone | 718-282-3340
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Fax | 718-469-4616
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Provider Business Mailing Address
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Address Line | 917 PINECROFT CT
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City | FRANKLIN LAKES
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State | NJ
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Zip | 07417-1711
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Country | US
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Telephone | 201-891-3597
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Fax | 201-891-3598
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 210407
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License Number State | NY
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