1548553464 NPI number — MRS. OLUWAMUYIWA BUSOLA ADEOLU NURSING

Table of content: MRS. OLUWAMUYIWA BUSOLA ADEOLU NURSING (NPI 1548553464)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548553464 NPI number — MRS. OLUWAMUYIWA BUSOLA ADEOLU NURSING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADEOLU
Provider First Name:
OLUWAMUYIWA
Provider Middle Name:
BUSOLA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NURSING
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548553464
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
225 PARK HILL AVE APT 2W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STATEN ISLAND
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10304-4740
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-801-9175
Provider Business Mailing Address Fax Number:
718-370-3145

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 PARKHILL AVE
Provider Second Line Business Practice Location Address:
APT 2W
Provider Business Practice Location Address City Name:
STATEN ISLAND
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-801-9175
Provider Business Practice Location Address Fax Number:
718-370-3145
Provider Enumeration Date:
05/25/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 164W00000X , with the licence number:  303884-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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