Provider Demographics
NPI:1487074134
Name:ODUNLADE, ADELOLA ARAMIDE
Entity type:Individual
Prefix:MS
First Name:ADELOLA
Middle Name:ARAMIDE
Last Name:ODUNLADE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CONGERS RD
Mailing Address - Street 2:APT. 4
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5141
Mailing Address - Country:US
Mailing Address - Phone:845-709-5122
Mailing Address - Fax:
Practice Address - Street 1:36 CONGERS RD
Practice Address - Street 2:APT. 4
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5141
Practice Address - Country:US
Practice Address - Phone:845-709-5122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY668332-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse