NPI Profile for OMOTARA J ADEWALE in STATEN ISLAND, NY.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI # | 1366985251 |
|
| Status | Active | |
| Credentials | MSN, NP-C, FNP-BC | |
| Entity | Individual | |
| Enumeration date | 11/23/2016 | |
| Last updated | 11/07/2025 - About 7 months ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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OMOTARA J ADEWALE
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