Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | F340755-1 | NY |
NPI | 1053645481 |
---|---|
Provider Name | Titilola O Abiodun-Adelokiki |
First Address | Staten Island, NY 10303-1601 |
Second Address | Staten Island, NY 10303-1601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2009 |
Last Update Date | 02/10/2009 |