Provider Demographics
NPI:1962030676
Name:ADEKOLA, OLANREWAJU IDRIS (MD)
Entity type:Individual
Prefix:DR
First Name:OLANREWAJU
Middle Name:IDRIS
Last Name:ADEKOLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LANRE
Other - Middle Name:
Other - Last Name:ADEKOLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:38 6TH AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-4350
Mailing Address - Country:US
Mailing Address - Phone:718-362-3260
Mailing Address - Fax:718-230-4235
Practice Address - Street 1:38 6TH AVE FL 4
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-4350
Practice Address - Country:US
Practice Address - Phone:718-362-3260
Practice Address - Fax:718-230-4235
Is Sole Proprietor?:No
Enumeration Date:2020-03-29
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61333179207Q00000X
NY326137207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine