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NPI Code Detail

MEDICARE: ADEBOLA ADENIKE ABIOLA PT

MEDICARE: ADEBOLA ADENIKE ABIOLA PT
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
1225100000XPhysical Therapist40QAO994500NJ

General Provider Information

NPI Number : 1750593406
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADEBOLA ADENIKE ABIOLA PT
Provider Business Mailing Address
First Line : 129 GOLDEN MEADOW LN
Second Line :
City : SICKLERVILLE
State : NJ
Zip : 08081-9304
Country : US
Telephone Number : 609-561-1667
Fax Number :
Provider Business Practice Location Address
First Line : 2150 ROUTE 38
Second Line :
City : CHERRY HILL
State : NJ
Zip : 08002-4302
Country : US
Telephone Number : 856-667-4550
Fax Number : 856-667-3507
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2007
Last Update Date : 07/08/2007

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