| Doctor Name: | DR. SAMUEL BABATUNDE ADEGBOYEGA |
| NPI Number: | 1124281233 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | 006368 |
| Business Practice Address: | 67 Broadway Elmwood Park, NJ - 074071836 |
| Business Phone Number: | 2017943223 |
| Business Fax Number: | 2017948411 |
| Mailing Address: | 460 Hancock St, RAHWAY |
| State: | NJ |
| Postal Code: | 070655158 |
| Phone Number: | 9732071678 |
| Fax Number: | 2017948411 |
| NPI Enumeration Date: | 07/08/2008 |
| NPI Last Update Date: | 02/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 006368 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |