1144324559 NPI number — TOKUNBO T DADA MD

Table of content: TOKUNBO T DADA MD (NPI 1144324559)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144324559 NPI number — TOKUNBO T DADA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DADA
Provider First Name:
TOKUNBO
Provider Middle Name:
T
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:
1144324559
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/04/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
50 UNION AVENUE
Provider Second Line Business Mailing Address:
SUTIE 702
Provider Business Mailing Address City Name:
IRVINGTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-373-7110
Provider Business Mailing Address Fax Number:
973-373-0076

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 UNION AVENUE
Provider Second Line Business Practice Location Address:
SUTIE 702
Provider Business Practice Location Address City Name:
IRVINGTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-373-7110
Provider Business Practice Location Address Fax Number:
973-373-0076
Provider Enumeration Date:
09/08/2006

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: 208000000X , with the licence number:  25MA04826700 , 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: 343730201 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com