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NPI Code Detail

MEDICARE: DR. BABATUNDE OLUSEGUN ADEBOYE PHARM.D, M.B.A

MEDICARE: DR. BABATUNDE OLUSEGUN ADEBOYE PHARM.D, M.B.A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P1200XPharmacotherapy Pharmacist28RI03811000NJ

General Provider Information

NPI Number : 1184171449
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BABATUNDE OLUSEGUN ADEBOYE PHARM.D, M.B.A
Provider Business Mailing Address
First Line : 1633 SPRINGFIELD AVE
Second Line :
City : MAPLEWOOD
State : NJ
Zip : 07040-2922
Country : US
Telephone Number : 973-761-7391
Fax Number :
Provider Business Practice Location Address
First Line : 1633 SPRINGFIELD AVE
Second Line :
City : MAPLEWOOD
State : NJ
Zip : 07040-2922
Country : US
Telephone Number : 973-761-7391
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2016
Last Update Date : 09/04/2016

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