Healthcare Provider Details

I. General information

NPI: 1972448843
Provider Name (Legal Business Name): FREDERICK ABIODUN ADELOKIKI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: TITILOLA OLIVIA ADELOKIKI NP

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 RICHMOND RD
STATEN ISLAND NY
10304-2413
US

IV. Provider business mailing address

89 ARLINGTON AVE
STATEN ISLAND NY
10303-1601
US

V. Phone/Fax

Practice location:
  • Phone: 917-678-3509
  • Fax:
Mailing address:
  • Phone: 917-678-3509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: