Basic Information
| Provider Information | |||||||||
| NPI: | 1922237163 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADEPOJU | ||||||||
| FirstName: | GRACE | ||||||||
| MiddleName: | ADEOLA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP IN PSYCHIATRY | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 14890 | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122124890 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5185255634 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3 MERCYCARE LN | ||||||||
| Address2: | |||||||||
| City: | GUILDERLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 120843504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184526700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2009 | ||||||||
| LastUpdateDate: | 03/17/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 305116 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LP0808X | 401590 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.