Individual provider Active NPI

Olufunke Ayodele Adefila, REGISTERED NURSE

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1396407722
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
966059 Issued in NY
Practice address
1103 E 216TH St # a
Bronx, NY 10469-2301
Phone
(646) 945-3059
NPI assigned
Oct 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 966059 NY Primary

Addresses

Primary practice location

1103 E 216TH St # a
Bronx, NY 10469-2301

Mailing address

1103 E 216TH St Apt a
Bronx, NY 10469-2301
Phone (646) 945-3059

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

LicenseStateTypeSpecialty
966059NYMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1396407722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 E 216TH ST APT A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104692301",
            "telephone_number": "646-945-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 E 216TH ST # A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104692301",
            "telephone_number": "646-945-3059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEFILA",
        "first_name": "OLUFUNKE",
        "middle_name": "AYODELE",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "966059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.