Atinuke Alari Abudu

Individual provider Active NPI Licensed Practical Nurse · Roosevelt, NY

NPI 1942912902 · NPPES record last updated Dec 21, 2022

Key facts

NPI
1942912902
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
338390-01 (NY)
Practice address
45 Delisle Ave
Roosevelt, NY 11575-2520
Phone
(347) 755-1686
NPI assigned
Dec 21, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
338390-01NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 338390-01 NY Yes

Addresses

Primary practice location

45 Delisle Ave
Roosevelt, NY 11575-2520

Mailing address

45 Delisle Ave
Roosevelt, NY 11575-2520
Phone (347) 755-1686

Other providers in Roosevelt, NY

All providers in Roosevelt, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.