Omotayo Fakorode

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

648044 Issued in NY

Practice address

77 Fraser St
Staten Island, NY 10314-6111

Phone

(718) 664-3438

NPI assigned

Nov 18, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1290038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1902108269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 FRASER ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146111",
            "telephone_number": "718-664-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 FRASER ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146111",
            "telephone_number": "718-664-3438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKORODE",
        "first_name": "OMOTAYO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-18",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "263598",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "648044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Fairlie, ANP,GNP,FNP,CDE
• Javonne Faison
• Faith and Hope Psychotherapy, LCSW, PLLC
• Yaela E Faitlowicz-Gayer, DDS
• Farzad Fakheri, MD
• Amanda Antoinette Falco, P.A.
• Falcon Medical Inc
• Jonathan Ryan Falcone, OTR/L
• Joseph Anthony Falcone Sr., NP
• Kerry Ann Falcone, OTR/L

• Registered Nurse in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; 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.