MEDICARE: ADERONKE ASHABI OMOLOLA LPN

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	164W00000X	Licensed Practical Nurse	300983	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	300983	OTHER	NY	LICENCE PRACTICAL NURSE

General Provider Information

NPI Number	:	1497068159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADERONKE ASHABI OMOLOLA LPN

Provider Business Mailing Address
First Line	:	13318 161ST ST
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11434-2932
Country	:	US
Telephone Number	:	718-413-2369
Fax Number	:

Provider Business Practice Location Address
First Line	:	13318 161ST ST
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11434-2932
Country	:	US
Telephone Number	:	718-413-2369
Fax Number	:

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

Provider Enumeration Date	:	07/22/2010
Last Update Date	:	07/22/2010

Similar Medicare Providers

1760847990 — DR. CLEOLENE EUGENIE JONES
Practice Location Address:

10912 169TH PL
JAMAICA, NY
11433-2932

Practice Phone: 718-739-9046
Practice Fax:

1821724055 — SHRINE PHARMACY INC
Practice Location Address:

13124 ROCKAWAY BLVD
JAMAICA, NY
11420-2932

Practice Phone: 718-413-8830
Practice Fax:

1497618094 — TRISHA ALLY
Practice Location Address:

12218 LONG ST
JAMAICA, NY
11434-2420

Practice Phone: 347-968-8035
Practice Fax:

1992826994 — DR. ALICIA MASSOP-FLOWERS D.O.
Practice Location Address:

13130 MERRICK BLVD
JAMAICA, NY
11434-4134

Practice Phone: 718-233-2556
Practice Fax: 718-233-2569

1962366120 — AMINAH DANTZLER RN
Practice Location Address:

17230 133RD AVE APT 11B
JAMAICA, NY
11434-3918

Practice Phone: 929-691-2273
Practice Fax:

1659673986 — JESSICA BORRERO PA
Practice Location Address:

11515 SUTPHIN BLVD
JAMAICA, NY
11434-1020

Practice Phone: 718-765-6009
Practice Fax: 347-682-4302

Directions to “ ADERONKE ASHABI OMOLOLA LPN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.