Healthcare Provider Details

I. General information

NPI: 1770936791
Provider Name (Legal Business Name): SOLOMON ALUKO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2016
Last Update Date: 12/07/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1432 5TH AVE
NEW YORK NY
10035-4521
US

IV. Provider business mailing address

600 CLEMENTS BRIDGE RD
BARRINGTON NJ
08007-1814
US

V. Phone/Fax

Practice location:
  • Phone: 646-289-7700
  • Fax:
Mailing address:
  • Phone: 856-547-8000
  • Fax: 856-547-1008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF342455
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: