Emmanuel A Adesanlu, NP
Individual provider Active NPI Registered Nurse · Bronx, NY
NPI 1710694039 · NPPES record last updated Nov 7, 2022
Key facts
- NPI
- 1710694039
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 721715 (NY)
- Practice address
- 1334 Louis Nine Blvd Apt 5a
Bronx, NY 10459-2298 - Phone
- (646) 730-4162
- NPI assigned
- Nov 7, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 721715 | NY | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 721715 | NY | Yes |
Addresses
Primary practice location
1334 Louis Nine Blvd Apt 5a
Bronx, NY 10459-2298
Mailing address
1334 Louis Nine Blvd Apt 5a
Bronx, NY 10459-2298
Phone (646) 730-4162
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | 08:f8:bc:65:ed:84 |
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.