Taiwo Kalejaiye Olatunji-Ikuomenisan, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

313350-1 Issued in NY

Practice address

133A Columbia St
Huntington Station, NY 11746-1221

Phone

(631) 827-5675

NPI assigned

Feb 12, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360627200000",
    "number": "1407195423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133A COLUMBIA ST",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461221",
            "telephone_number": "631-827-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133A COLUMBIA ST",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461221",
            "telephone_number": "631-827-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLATUNJI-IKUOMENISAN",
        "first_name": "TAIWO",
        "middle_name": "KALEJAIYE",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-12",
        "last_updated": "2013-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "313350-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa O'Neill, LCAT
• Margaret Obrien
• Yetunde Ogunbanwo, FNP
• Yu Shin Oh, DPT
• Cristina I. Okada Nishikawa, MS-SLP
• Aydin Mehmet Olgun, DO
• Mauricio Miguel Orellana, PHARMD
• Orthopedic Spine Care of Long Island PC
• Johnhanna Jennyffer Otero
• Katie Michele Pacinelli, D.C.

• Licensed Practical Nurse in Huntington Station, NY
• Providers in Huntington Station, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.