Healthcare Provider Details

I. General information

NPI: 1578837613
Provider Name (Legal Business Name): MURAINA A ADELABU RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MURAINA A ADELABU RN

II. Dates (important events)

Enumeration Date: 03/07/2012
Last Update Date: 03/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FORDHAM PLZ RM 749 NEW YORK CITY DEPT. OF EDUCATION
BRONX NY
10458-5871
US

IV. Provider business mailing address

446 TURNEUR AVE SUITE 1
BRONX NY
10473-1621
US

V. Phone/Fax

Practice location:
  • Phone: 718-741-3051
  • Fax: 718-329-8155
Mailing address:
  • Phone: 718-741-3051
  • Fax: 718-329-8155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number459447
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: