Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 25MD00313500 | NJ |
Y | 222Z00000X | Podiatrist | 25MD00313500 | NJ |
N | 213EP1101X | Primary Podiatric Medicine | 25MD00313500 | NJ |
N | 213ES0103X | Foot & Ankle Surgery | 25MD00313500 | NJ |
N | 213ES0103X | Foot & Ankle Surgery | 65P71601 | NY |
N | 213ES0103X | Foot & Ankle Surgery | SC006259 | PA |
N | 213ES0131X | Foot Surgery | 25MD00313500 | NJ |
NPI | 1124327309 |
---|---|
Provider Name | Dr. Olukola A Adeleke |
First Address | Erial, NJ 08081-3240 |
Second Address | Ewing, NJ 08618-2669 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2011 |
Last Update Date | 07/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0315486 | (05) | NJ |