Individual provider Active NPI

Adijat Omotoke Lawal, L.P.N

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1841520194
Registry record updated Jan 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
252015-1 Issued in NY
Practice address
1134 E 99TH St
Brooklyn, NY 11236-4424
Phone
(171) 853-1785
NPI assigned
Jan 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 252015-1 NY Primary
Licensed Practical Nurse 164W00000X L 050728-6 MN

Addresses

Primary practice location

1134 E 99TH St
Brooklyn, NY 11236-4424

Mailing address

1184 Frisbie Ave
Maplewood, MN 55109-4326
Phone (651) 206-3038

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

LicenseStateTypeSpecialty
L 050728-6MNMDLicensed Practical Nurse
252015-1NYMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1262995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262995200000",
    "number": "1841520194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1184 FRISBIE AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551094326",
            "telephone_number": "651-206-3038",
            "fax_number": "651-793-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 E 99TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364424",
            "telephone_number": "171-853-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWAL",
        "first_name": "ADIJAT",
        "middle_name": "OMOTOKE",
        "credential": "L.P.N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-09",
        "last_updated": "2010-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "252015-1",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MN",
            "license": "L 050728-6",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2010; 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.