Individual
ADEREMI SOYOMBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
22-18 BROADWAY, SUITE 201, FAIR LAWN, NJ 07410-3016
(201) 475-5050
(201) 475-5522
Mailing address
22-18 BROADWAY, SUITE 201, FAIR LAWN, NJ 07410-3016
(201) 475-5050
(201) 475-5522
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
25MA08557600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0207021
—
NJ
Enumeration date
05/16/2008
Last updated
09/17/2012
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