Adewunmi Julius Bankole NP in Psychiatry PLLC
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Rockville Centre, NY
NPI 1487401816 · NPPES record last updated May 3, 2024
Key facts
- NPI
- 1487401816
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- ADEWUNMI JULIUS BANKOLE NP IN PSYCHIATRY PLLC
- Practice address
- 165 N Village Ave Ste 12
Rockville Centre, NY 11570-3701 - Phone
- (516) 350-8564
- Fax
- (516) 874-2477
- NPI assigned
- May 3, 2024
- Organization subpart
- No
Authorized official
- Name
- Adewunmi Julius Bankole, PMHNP
- Title
- Owner
- Phone
- (516) 350-8564
Practitioners 1
-
Adewunmi Julius Bankole, NURSE PRACTITIONER
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240621002877 | NY | Part B Supplier - Clinic/Group Practice | 1658814397 |
Receives reassigned benefits from 1 practitioner Practice locations: Staten Island, NY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
165 N Village Ave Ste 12
Rockville Centre, NY 11570-3701
Mailing address
165 N Village Ave Ste 12
Rockville Centre, NY 11570-3701
Phone (516) 350-8564
Other providers in Rockville Centre, NY
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- Justine Eleanor Adam
- Lynn Ann Adams
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- Advantage Health Inc.
- Tanisha Shante Afzal
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All providers in Rockville Centre, NY · Psychiatric/Mental Health Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.