ABIDEMI ADETOYESE ADEGBOLA


Address: 3905 Ford Rd, Suite 6, Philadelphia, PA 19131-2824
Phone: 2152202196

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 3905 FORD RD
SUITE 6
City PHILADELPHIA
State PA
Zip Code 19131-2824

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207SG0201X
Grouping Allopathic & Osteopathic Physicians
Classification Medical Genetics
Specialization Clinical Genetics (M.D.)

Taxonomy Definition

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.

Providers in the same taxonomy and city

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
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Competitor

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City PHILADELPHIA
Zip Code 19131

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Dataset Information

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.

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