MEDICARE: MRS. JOYCE OLUFUNKE ADEDUGBE NP-C

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
1	363LA2200X	Adult Health Nurse Practitioner	304978	NY
2	363LA2200X	Adult Health Nurse Practitioner	F304978	NY

General Provider Information

NPI Number	:	1285889568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOYCE OLUFUNKE ADEDUGBE NP-C

Provider Business Mailing Address
First Line	:	437 OLD COUNTRY RD
Second Line	:
City	:	MELVILLE
State	:	NY
Zip	:	11747-1819
Country	:	US
Telephone Number	:	516-205-2430
Fax Number	:	631-608-2879

Provider Business Practice Location Address
First Line	:	150 E SUNRISE HIGHWAY
Second Line	:	SUITE L20
City	:	LINDENHURST
State	:	NY
Zip	:	11757-2539
Country	:	US
Telephone Number	:	631-608-2878
Fax Number	:	631-608-2879

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2008
Last Update Date	:	03/28/2024

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