Doctor Name: | DARE I ADEYELE |
NPI Number: | 1972849560 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 60 267278 |
Business Practice Address: | 2015 Grand Concourse, Essen Medical Bronx, NY - 104538648 |
Business Phone Number: | 7187312020 |
Business Fax Number: | 7182946276 |
Mailing Address: | 8647 164th St # 31, Jamaica JAMAICA |
State: | NY |
Postal Code: | 114323450 |
Phone Number: | 7182883332 |
Fax Number: | |
NPI Enumeration Date: | 12/31/2012 |
NPI Last Update Date: | 12/31/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 60 267278 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |