Provider Demographics
NPI:1972481067
Name:AJIBODE, FLORA NNEAMAKA (RN)
Entity type:Individual
Prefix:MRS
First Name:FLORA
Middle Name:NNEAMAKA
Last Name:AJIBODE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 CALEBS PATH
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722-1040
Mailing Address - Country:US
Mailing Address - Phone:631-629-9750
Mailing Address - Fax:
Practice Address - Street 1:227 CALEBS PATH
Practice Address - Street 2:
Practice Address - City:CENTRAL ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11722-1040
Practice Address - Country:US
Practice Address - Phone:631-629-9750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN03373163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse