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NPI Code Detail

MEDICARE: OMOLARA EUNICE ADEBANJO

MEDICARE: OMOLARA EUNICE ADEBANJO
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 Nurse353850NY

General Provider Information

NPI Number : 1548113939
Entity Type Code : Individual
Provider Name (Legal Business Name) : OMOLARA EUNICE ADEBANJO
Provider Business Mailing Address
First Line : 26 DUMONT AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10305-1450
Country : US
Telephone Number : 718-667-4282
Fax Number :
Provider Business Practice Location Address
First Line : 26 DUMONT AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10305-1450
Country : US
Telephone Number : 718-667-4282
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2026
Last Update Date : 02/17/2026

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Directions to “ OMOLARA EUNICE ADEBANJO ” Practice Location

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