Active NPI
Moriam T Bolaji
- Health Educator
- Brooklyn, NY
National Provider Identifier
1063277192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- License
- 2787706
- Practice address
- 42 Lincoln Ave Apt 1L
Brooklyn, NY 11208-1538 - Phone
- (347) 337-4800
- NPI assigned
- Feb 19, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | 2787706 | NY | Primary |
Addresses
Primary practice location
42 Lincoln Ave Apt 1L
Brooklyn, NY 11208-1538
Mailing address
42 Lincoln Ave Apt 1L
Brooklyn, NY 11208-1538
Phone (347) 337-4800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2787706 | NY | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708300800000",
"number": "1063277192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42 LINCOLN AVE APT 1L",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112081538",
"telephone_number": "347-337-4800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42 LINCOLN AVE APT 1L",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112081538",
"telephone_number": "347-337-4800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLAJI",
"first_name": "MORIAM",
"middle_name": "T",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-19",
"last_updated": "2024-02-19",
"certification_date": "2024-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "NY",
"license": "2787706",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.