Provider Demographics
NPI:1235825894
Name:ADENAIKE, MUSAFAU OLADIRAN (PMHNP)
Entity type:Individual
Prefix:
First Name:MUSAFAU
Middle Name:OLADIRAN
Last Name:ADENAIKE
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07107-4197
Mailing Address - Country:US
Mailing Address - Phone:973-517-0123
Mailing Address - Fax:
Practice Address - Street 1:260 CHRISTOPHER LN STE 102A
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-1631
Practice Address - Country:US
Practice Address - Phone:914-295-9323
Practice Address - Fax:315-612-9793
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-17
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF405742363LP0808X
NJ26NJ01469400363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health