MEDICARE: FUNMILOLA ADENIKE AKERELE FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	728734	NY
2	164W00000X	Licensed Practical Nurse	303999	NY
3	363LF0000X	Family Nurse Practitioner	357223	NY

General Provider Information

NPI Number	:	1225332158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FUNMILOLA ADENIKE AKERELE FNP

Provider Business Mailing Address
First Line	:	141 BEACH 56TH PL APT 906
Second Line	:
City	:	ARVERNE
State	:	NY
Zip	:	11692-1918
Country	:	US
Telephone Number	:	347-393-5684
Fax Number	:

Provider Business Practice Location Address
First Line	:	133 MERIDIAN BLVD
Second Line	:
City	:	ARVERNE
State	:	NY
Zip	:	11692-2021
Country	:	US
Telephone Number	:	347-393-5684
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2011
Last Update Date	:	06/30/2025

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