Serifat Adeyemi
Individual provider Active NPI Registered Nurse · Bronx, NY
NPI 1255939005 · NPPES record last updated Apr 14, 2021
Key facts
- NPI
- 1255939005
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 811125 (NY)
- Practice address
- 830 E 214TH St
Bronx, NY 10467-5914 - Phone
- (646) 881-1720
- NPI assigned
- Oct 14, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 811125 | NY | MD | Registered Nurse |
| 339314 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 339314 | NY | |
| Registered Nurse | 163W00000X | 811125 | NY | Yes |
Addresses
Primary practice location
830 E 214TH St
Bronx, NY 10467-5914
Mailing address
830 E 214TH St
Bronx, NY 10467-5914
Phone (646) 881-1720
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.