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Contact Information

OMOTARA J ADEWALE, MSN, NP-C, FNP-BC
260 CHRISTOPHER LN STE 201
STATEN ISLAND, NY10314-1650
 Phone: 929-367-0510
 Fax: 929-367-0511
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for OMOTARA J ADEWALE · (Female)

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
  • NY License # F341251-1
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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