Healthcare Provider Details

I. General information

NPI: 1083372247
Provider Name (Legal Business Name): FOLAKE OLALEYE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2021
Last Update Date: 12/06/2021
Certification Date: 12/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 DEKALB AVE
BROOKLYN NY
11201-5425
US

IV. Provider business mailing address

15412 107TH AVE
JAMAICA NY
11433-1906
US

V. Phone/Fax

Practice location:
  • Phone: 718-250-7900
  • Fax:
Mailing address:
  • Phone: 718-206-0933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number067746
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: