Oludare Abayomi Adesanya, PEER COUNSELOR

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Bronx, NY

NPI 1295396117 · NPPES record last updated Jun 21, 2019

Key facts

NPI
1295396117
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CARC-1206 (NY)
Practice address
1400 Pelham Pkwy S
Bronx, NY 10461-1197
Phone
(718) 918-4465
NPI assigned
Jun 21, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CARC-1206NYMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CARC-1206 NY Yes

Addresses

Primary practice location

1400 Pelham Pkwy S
Bronx, NY 10461-1197

Mailing address

1400 Pelham Pkwy S
Bronx, NY 10461-1197
Phone (718) 918-4465

Other providers in Bronx, NY

All providers in Bronx, NY · Addiction (Substance Use Disorder) Counselor in New York

Sources for this page

Verify at the official NPI Registry.