Healthcare Provider Details

I. General information

NPI: 1487013629
Provider Name (Legal Business Name): ADETUTU LATEEFAT SONEYE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2016
Last Update Date: 02/28/2026
Certification Date: 02/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 DIXON AVE
STATEN ISLAND NY
10303-2804
US

IV. Provider business mailing address

243 HARDING BLVD
MATAWAN NJ
07747-2912
US

V. Phone/Fax

Practice location:
  • Phone: 516-234-1183
  • Fax: 609-248-0943
Mailing address:
  • Phone: 516-234-1183
  • Fax: 609-248-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NRJ14984600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NRJ14984600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: