Individual
DR. OLUWOLE AYODEJI TAIRU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
150 BERGEN ST LEVEL C, NEWARK, NJ 07103-2496
(973) 972-2161
(973) 972-2307
Mailing address
30 BERGEN ST ADMC 12 1205, NEWARK, NJ 07107-3000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA09688800
NJ
2085R0202X
Diagnostic Radiology Physician
275287
NY
Other
Enumeration date
06/02/2009
Last updated
07/15/2015
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