Individual ProviderTaiwo GbadeboNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address502 Centennial Blvd Ste 3, Voorhees, NJ 08043-9544(856) 751-2300PECOS EnrollmentBased on the most recent information from CMS, provider Taiwo Gbadebo is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1700201241Provider TypeIndividualFull NameGbadebo, TaiwoCredentialAPNGenderFemaleSole ProprietorYesEnumeration Date2/20/2014Last Updated11/8/2024Contact InformationPractice LocationPractice Address502 Centennial Blvd Ste 3, Voorhees, NJ 08043-9544Phone(856) 751-2300Fax(856) 751-2333Mailing LocationMailing Address301 Lippincott Dr Ste 410, Marlton, NJ 08053-4197Phone(856) 751-2300Fax(856) 751-2333Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense26NR13633700New JerseyCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseSP012781PennsylvaniaProvider IdentifiersIDDescriptionIssuerID0410217DescriptionMedicaidIssuerUnlistedNew Jersey