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General NPI Number Information
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NPI Number | 1689417982
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Entity Type | Individual
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Provider Name | OLUWATOYIN ODUNAYO ADEGOKE NP
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Gender | Female
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Dates
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Enumeration Date | 06/14/2024
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Last Update Date | 06/14/2024
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Provider Practice Location Address
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Address Line | 134 W EAGLE ST FL 5
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City | BUFFALO
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State | NY
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Zip | 14202-3804
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Country | US
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Telephone | 718-858-8090
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Fax |
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Provider Business Mailing Address
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Address Line | 3581 BIG TREE RD UNIT 14
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City | HAMBURG
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State | NY
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Zip | 14075-1737
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Country | US
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Telephone | 716-398-1218
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 720801
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 351982
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License Number State | NY
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