Healthcare Provider Details

I. General information

NPI: 1699386896
Provider Name (Legal Business Name): ULELE OKOLO ADAMS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2020
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1519 E 98TH ST
BROOKLYN NY
11236-5321
US

IV. Provider business mailing address

1519 E 98TH ST
BROOKLYN NY
11236-5321
US

V. Phone/Fax

Practice location:
  • Phone: 134-766-1382
  • Fax:
Mailing address:
  • Phone: 134-766-1382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License NumberF309817-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF309817-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: