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

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
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

All providers in Rockville Centre, NY · Psychiatric/Mental Health Nurse Practitioner in New York

Sources for this page

Verify at the official NPI Registry.