Healthcare Provider Details

I. General information

NPI: 1700230505
Provider Name (Legal Business Name): AMINAT ADETOUN AKINTOLA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMINAT ADETOUN AKINTOLA MSN, FNP

II. Dates (important events)

Enumeration Date: 04/18/2016
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

796A SARATOGA AVE
BROOKLYN NY
11212-4444
US

IV. Provider business mailing address

451 CLARKSON AVE
BROOKLYN NY
11203-2054
US

V. Phone/Fax

Practice location:
  • Phone: 718-685-8737
  • Fax: 347-365-4230
Mailing address:
  • Phone: 718-685-8737
  • Fax: 347-365-4230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number685059
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number685059
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number343699
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: