Active NPI
Bimbola Komolafe
- Nursing Care Agency
- Bronx, NY
National Provider Identifier
1417588740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Care Agency
- License
- 329612-1
- Practice address
- 3910 Harper Ave Apt 31B
Bronx, NY 10466-2499 - Phone
- (646) 626-3912
- NPI assigned
- Jan 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nursing Care Agency | 251J00000X | 329612-1 | NY | Primary |
Addresses
Primary practice location
3910 Harper Ave Apt 31B
Bronx, NY 10466-2499
Mailing address
3910 Harper Ave Apt 31B
Bronx, NY 10466-2499
Phone (646) 626-3912
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 |
|---|---|---|---|
| 329612-1 | NY | MD | Nursing Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580083200000",
"number": "1417588740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3910 HARPER AVE APT 31B",
"city": "BRONX",
"state": "NY",
"postal_code": "104662499",
"telephone_number": "646-626-3912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3910 HARPER AVE APT 31B",
"city": "BRONX",
"state": "NY",
"postal_code": "104662499",
"telephone_number": "646-626-3912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOMOLAFE",
"first_name": "BIMBOLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-27",
"last_updated": "2020-01-27",
"certification_date": "2020-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": "NY",
"license": "329612-1",
"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 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.