MEDICARE: OLURANTI ADEOSHUN

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	163WS0200X	School Registered Nurse	636245	NY

General Provider Information

NPI Number	:	1730489766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLURANTI ADEOSHUN

Provider Business Mailing Address
First Line	:	1548 E NEW YORK AVE
Second Line	:	9H
City	:	BROOKLYN
State	:	NY
Zip	:	11212-6862
Country	:	US
Telephone Number	:	347-405-7238
Fax Number	:

Provider Business Practice Location Address
First Line	:	1548 E NEW YORK AVE
Second Line	:	9H
City	:	BROOKLYN
State	:	NY
Zip	:	11212-6862
Country	:	US
Telephone Number	:	347-405-7238
Fax Number	:

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

Provider Enumeration Date	:	10/25/2010
Last Update Date	:	10/25/2010

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Directions to “ OLURANTI ADEOSHUN ” Practice Location

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