MEDICARE: DR. ADEDAYO ADEDEJI M.D.

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
1	207RI0200X	Infectious Disease Physician	212659	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285621698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADEDAYO ADEDEJI M.D.

Provider Business Mailing Address
First Line	:	1408 RICHMOND ROAD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304
Country	:	US
Telephone Number	:	718-979-5646
Fax Number	:	718-979-5650

Provider Business Practice Location Address
First Line	:	1408 RICHMOND ROAD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304
Country	:	US
Telephone Number	:	718-979-5646
Fax Number	:	718-979-5650

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	09/09/2010

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Directions to “ DR. ADEDAYO ADEDEJI M.D.” Practice Location

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