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General NPI Number Information
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NPI Number | 1679467435
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Entity Type | Organization
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Legal Business Name | O.A. ADULT HEALTH NP P.C.
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Dates
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Enumeration Date | 06/05/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 878 CASTLETON AVE GROUND FLOOR
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City | STATEN ISLAND
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State | NY
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Zip | 10310-1865
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Country | US
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Telephone | 718-218-5666
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Fax |
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Provider Business Mailing Address
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Address Line | 878 CASTLETON AVE GROUND FLOOR
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City | STATEN ISLAND
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State | NY
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Zip | 10310-1865
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Country | US
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Telephone | 718-218-5666
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | OMOWUNMI O. ABAYOMI
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Credential | NP
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Telephone | 718-218-5666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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