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NPI Code Detail

MEDICARE: MUSTAPHA ADEKUNLE AJOSE

MEDICARE: MUSTAPHA ADEKUNLE AJOSE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse3326571NY

General Provider Information

NPI Number : 1225677289
Entity Type Code : Individual
Provider Name (Legal Business Name) : MUSTAPHA ADEKUNLE AJOSE
Provider Business Mailing Address
First Line : 861 FOREST AVE APT 2
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10310-2439
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 861 FOREST AVE APT 2
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10310-2439
Country : US
Telephone Number : 347-856-4177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2019
Last Update Date : 12/22/2019

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Directions to “ MUSTAPHA ADEKUNLE AJOSE ” Practice Location

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