Healthcare Provider Details

I. General information

NPI: 1285580159
Provider Name (Legal Business Name): SAKIRAT FOLASADE IBRAHIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1704 PHEASANT RUN
MONMOUTH JUNCTION NJ
08852-1941
US

IV. Provider business mailing address

1704 PHEASANT RUN
MONMOUTH JUNCTION NJ
08852-1941
US

V. Phone/Fax

Practice location:
  • Phone: 443-410-6343
  • Fax:
Mailing address:
  • Phone: 443-410-6343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number26NJ15508100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: