Provider Demographics
NPI:1801119847
Name:OSINAIKE, ADEBOLA (NP)
Entity type:Individual
Prefix:
First Name:ADEBOLA
Middle Name:
Last Name:OSINAIKE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 FORBELL ST
Mailing Address - Street 2:APT-1F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-4776
Mailing Address - Country:US
Mailing Address - Phone:347-365-3560
Mailing Address - Fax:
Practice Address - Street 1:922 FORBELL ST
Practice Address - Street 2:APT-1F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-4776
Practice Address - Country:US
Practice Address - Phone:718-671-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299973164W00000X
NYF355162-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No164W00000XNursing Service ProvidersLicensed Practical Nurse