1487683397 NPI number — IBIJOKE ALADE MD

Table of content: IBIJOKE ALADE MD (NPI 1487683397)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487683397 NPI number — IBIJOKE ALADE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALADE
Provider First Name:
IBIJOKE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487683397
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/29/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
813 MAIDEN CHOICE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21228-3679
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-402-2258
Provider Business Mailing Address Fax Number:
410-204-7279

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 CEDAR CREST VILLAGE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POMPTON PLAINS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07444-2100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-831-3540
Provider Business Practice Location Address Fax Number:
973-831-3503
Provider Enumeration Date:
07/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  25MA07555000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0100714 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0409721 . This is a "EVERCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5221142040 . This is a "BCBS OF NJ" identifier . This identifiers is of the category "OTHER".
  • Identifier: 522114204 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".