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NPI Code Detail

MEDICARE: DR. GODWIN EKUNDAYO FAKEYE DNP, F.N.P, PMHNP

MEDICARE: DR. GODWIN EKUNDAYO FAKEYE DNP, F.N.P, PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner403019NY
2363LF0000XFamily Nurse PractitionerF338932NY

General Provider Information

NPI Number : 1447649447
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GODWIN EKUNDAYO FAKEYE DNP, F.N.P, PMHNP
Provider Business Mailing Address
First Line : 1159 E 83RD ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-4703
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 760 BROADWAY
Second Line :
City : BROOKLYN
State : NY
Zip : 11206-5383
Country : US
Telephone Number : 718-963-8000
Fax Number : 718-486-2773
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2015
Last Update Date : 10/04/2022

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