Provider Demographics
NPI:1467332015
Name:ADENIJI, TASLEEM ADEMOLA
Entity type:Individual
Prefix:
First Name:TASLEEM
Middle Name:ADEMOLA
Last Name:ADENIJI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 CLINTON PL FL 1
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-1741
Mailing Address - Country:US
Mailing Address - Phone:973-393-8699
Mailing Address - Fax:
Practice Address - Street 1:413 CLINTON PL FL 1
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-1741
Practice Address - Country:US
Practice Address - Phone:973-393-8699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF407458363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health