Individual provider Active NPI

Olugbenga Okunoye

  • Licensed Practical Nurse
  • Staten Island, NY
National Provider Identifier
1962722124
Registry record updated Jun 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
294669 Issued in NY
Practice address
91 Townsend Ave
Staten Island, NY 10304-3713
Phone
(347) 424-5347
Fax
(718) 876-0390
NPI assigned
Jun 10, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 294669 NY
Licensed Practical Nurse 164W00000X 294669 NY Primary
Licensed Vocational Nurse 164X00000X 294669 NY

Addresses

Primary practice location

91 Townsend Ave
Staten Island, NY 10304-3713

Mailing address

91 Townsend Ave
Staten Island, NY 10304-3713
Phone (347) 424-5347

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
294669NYMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276128000000",
    "number": "1962722124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 TOWNSEND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043713",
            "telephone_number": "347-424-5347",
            "fax_number": "718-876-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 TOWNSEND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043713",
            "telephone_number": "347-424-5347",
            "fax_number": "718-876-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUNOYE",
        "first_name": "OLUGBENGA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-10",
        "last_updated": "2010-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "294669",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "294669",
            "primary": true
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "NY",
            "license": "294669",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.