Johnson Bolorunduro, RN

Primary specialty

Emergency Registered NurseTaxonomy code 163WE0003X

License

716854 Issued in NY

Practice address

4802 10TH Ave
Brooklyn, NY 11219-2916

Phone

(347) 258-1679

NPI assigned

Feb 1, 2017

Sex

Male

Sole proprietor

No

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1538607320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 BEVERLEY RD",
            "address_2": "APT 8B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112265477",
            "telephone_number": "347-258-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "347-258-1679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLORUNDURO",
        "first_name": "JOHNSON",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-01",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "NY",
            "license": "716854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelina Bolles, PHARMD
• Susan Marie Bolles, LCSW
• Yamini Bollineni
• Lea Mae Bolobanic, MSN, RN
• Nicolina A Bolognese, LCSW
• Queen Tabitha Bolorunduro
• Ekaterina Bolosova, NP
• Arie Bolshem, RPH
• Anna Bolshin, P.T.
• Dina Bolshinsky

• Emergency Registered Nurse in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Emergency Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.