Most Relevant Information
Provider Data
| NPI Number: | 1003061607 |
| Provider Name: | FAUSAT ADENIKE ADETOLA |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 293721-1 |
Most Important Dates
| Enumeration Date: | 11/24/2008 |
| Last Updated: | 11/24/2008 |
Provider Practice Location
40 W MOSHOLU PKWY S
APT 30A
BRONX
NY
104681150
Practice Location Phone/Fax
| Phone: | 3472387826 |
| Fax: |
Provider Mailing Location
40 W MOSHOLU PKWY S
APT 30A
BRONX
NY
104681150
Provider Mailing Phone/Fax
| Phone: | 3472387826 |
| Fax: |