Amudat O Adekunle
Individual provider Active NPI Driver · Toms River, NJ
NPI 1154889269 · NPPES record last updated Mar 7, 2019
Key facts
- NPI
- 1154889269
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- A18160407653732 (NJ)
- Practice address
- 30 Tilton Ave
Toms River, NJ 08757-5531 - Phone
- (732) 779-6041
- NPI assigned
- Mar 7, 2019
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A18160407653732 | NJ | MD | Driver |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Growing Heart Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver |
172A00000X | A18160407653732 | NJ | Yes |
Addresses
Primary practice location
30 Tilton Ave
Toms River, NJ 08757-5531
Mailing address
30 Tilton Ave
Toms River, NJ 08757-5531
Phone (732) 779-6041
Other providers in Toms River, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2019. 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.