Provider Demographics
NPI:1053645481
Name:ABIODUN-ADELOKIKI, TITILOLA O (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:TITILOLA
Middle Name:O
Last Name:ABIODUN-ADELOKIKI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:TITILOLA
Other - Middle Name:O
Other - Last Name:ABIODUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:89 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10303-1601
Mailing Address - Country:US
Mailing Address - Phone:718-816-3931
Mailing Address - Fax:
Practice Address - Street 1:89 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10303-1601
Practice Address - Country:US
Practice Address - Phone:718-816-3931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340755-1363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology