Emiola Omolola Adegbite, PT
Individual provider Active NPI Contractor · Deer Park, NY
NPI 1013057629 · NPPES record last updated Dec 15, 2008
Key facts
- NPI
- 1013057629
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 021492-1 (NY)
- Practice address
- 135 Fillmore Ave
Deer Park, NY 11729-7003 - Phone
- (516) 984-8347
- Fax
- (718) 327-3294
- NPI assigned
- Feb 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021492-1 | NY | MD | Contractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Dees PT Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 021492-1 | NY | Yes |
Addresses
Primary practice location
135 Fillmore Ave
Deer Park, NY 11729-7003
Mailing address
6915 Hillmeyer Ave
Arverne, NY 11692-1121
Phone (516) 984-8347
Other providers in Deer Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.