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Contact Information

ADETOKUNBO AJIBULU, PA
11949 UNION TPKE
APT # 5D
FOREST HILLS, NY11375-6151
 Phone: 646-321-6197
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for ADETOKUNBO AJIBULU · (Male)

NPI Number 1912919044
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 08/13/2006
Last updated 02/01/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 010505
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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