ABIDEMI ADETOYESE ADEGBOLA (NPI# 1669544169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1669544169 |
Entity Type | Individual |
Full Name | ABIDEMI ADETOYESE ADEGBOLA |
Credential | M.D |
Practice Address |
3905 Ford Rd Suite 6 Philadelphia PA 19131-2824 |
Mailing Address |
834 Chestnut St Ph113 Philadelphia PA 19107-5127 |
Practice Telephone | 2152202196 |
Mailing Telephone | 3143484546 |
Enumeration Date | 2006-11-14 |
Last Update Date | 2016-07-28 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
227766 | MA | Allopathic & Osteopathic Physicians |
N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
13062 | NH | Allopathic & Osteopathic Physicians |
N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
13062 | NH | Allopathic & Osteopathic Physicians |
Street Address |
3905 FORD RD SUITE 6 |
City | PHILADELPHIA |
State | PA |
Zip Code | 19131-2824 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003808106 | The Center for Autism | Occupational Therapist | 3905 Ford Rd, Suite 6, Philadelphia, PA 19131-2824 | 2005-08-16 |
1376165480 | Kristen M Cann | Behavioral Analyst | 3905 Ford Rd, Philadelphia, PA 19131-2824 | 2020-05-12 |
1003438227 | Carolynn Mcnamara | Counselor | 3905 Ford Rd, Philadelphia, PA 19131-2824 | 2020-05-11 |
1003437849 | Susan Lambert | Counselor | 3905 Ford Rd, Philadelphia, PA 19131-2824 | 2020-05-04 |
1073025987 | Kimberly Green | Counselor | 3905 Ford Rd, Philadelphia, PA 19131-2824 | 2017-11-01 |
1275044455 | Leah Leschinsky | Social Worker | 3905 Ford Rd, Philadelphia, PA 19131-2824 | 2017-10-16 |
1598202947 | Alison Mary Borden | Counselor | 3905 Ford Rd, Suite 6, Philadelphia, PA 19131-2824 | 2017-01-24 |
1609274125 | Kimberly Myles Ray | Social Worker | 3905 Ford Rd, Suite 600, Philadelphia, PA 19131-2824 | 2014-12-16 |
1033511472 | Krystal Carter | Counselor | 3905 Ford Rd, Suite 6, Philadelphia, PA 19131-2824 | 2014-09-17 |
1801203567 | Wordsworth Acute Partial Hospital | Community/Behavioral Health | 3905 Ford Rd, Philadelphia, PA 19131-2824 | 2014-07-15 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629678925 | Jonathan Welch | Student in an Organized Health Care Education/Training Program | 4200 E City Ave, Rowland Hall, Suite 207, Physician Assistant Department, Philadelphia, PA 19131 | 2020-10-27 |
1659970689 | Novacare Outpatient Rehabilitation East, Inc. | Clinic/Center | 1575 North 25nd Street, Philadelphia, PA 19131 | 2020-10-21 |
1821629254 | Stephen Osowski | Student in an Organized Health Care Education/Training Program | 4170 City Avenue, Philadelphia, PA 19131 | 2020-02-04 |
1134774888 | Arti D Mistry | Dentist | 1126 Horsham Road, Philadelphia, PW 19131 | 2019-08-08 |
1275187221 | Grace Bernadette Farrelly | Occupational Therapist | 2101 Simpson House, Philadelphia, PA 19131 | 2019-07-29 |
1235795204 | Isd Renal Inc | Clinic/Center | 4952 Parkside Ave, Philadelphia, PA 19131 | 2019-05-15 |
1922502582 | Kevin David Wojcik | Student in an Organized Health Care Education/Training Program | Philadelphia College of Osteopathic Medicine, 4190 City Ave, Philadelphia, PA 19131 | 2018-03-20 |
1235633900 | Nadja Hill | Home Health | 5203 Diamond Street, Philadelphia, PA 19131 | 2018-03-19 |
1932623857 | Mercy Management of Sepa | Social Worker | 1575 N 52nd St Ste 800, Philadelphia, PA 19131 | 2017-08-02 |
1578092235 | Sarah Marie Hoder | Specialist/Technologist | 4000 Presidential Avenue, Philadlephia, PA 19131 | 2017-06-07 |
Find all providers in zip 19131 |
Taxonomy Code | 207SG0201X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Medical Genetics |
Specialization | Clinical Genetics (M.D.) |
A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Medical Genetics, 2007. http://www.abmg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Medical Genetics. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922317759 | Mindy Li | Medical Genetics | 3615 Civic Center Blvd, Children's Hosp of Philadelphia, Room 1002 Abramson Res. Bldg, Dept of Medical Genetics, Philadelphia, PA 19104-4399 | 2010-09-28 |
1083857858 | Reena Natwarlal Jethva | Medical Genetics | 3601 A Street, 3rd Floor Acp, Suite 3314, St. Christopher's Hospital for Children, Philadelphia, PA 19134-1095 | 2009-04-09 |
1649324955 | Ghodrat P Sholevar | Medical Genetics | 618 W Lehigh Ave, Philadelphia, PA 19133 | 2007-01-23 |
1699878678 | Adele Schneider | Medical Genetics | 840 Walnut St Ste 1210, Philadelphia, PA 19107-5109 | 2006-09-06 |
1871139691 | Stc Opco LLC | Medical Genetics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-11-27 |
1396389805 | Stc Pediatrics LLC | Medical Genetics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-10-29 |
1336650456 | Kim Choong Wen Ng | Medical Genetics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2017-10-16 |
1396199543 | Rose Guo | Medical Genetics | 3401 Civic Center Blvd, Division of Human Genetics, Philadelphia, PA 19104 | 2016-04-13 |
1750776225 | Theodore George Drivas | Medical Genetics | 3400 Civic Center Blvd, Ste 3005, Philadelphia, PA 19104-5127 | 2015-04-01 |
1518355627 | University of Penn-medical Group | Medical Genetics | 3400 Spruce St, 8 Ravdin, Philadelphia, PA 19104-4238 | 2014-12-26 |
Find all providers in PHILADELPHIA |
City | PHILADELPHIA |
Zip Code | 19131 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.