Provider Demographics
NPI:1164152849
Name:OLATUNJI, ADEKUNLE
Entity Type:Individual
Prefix:
First Name:ADEKUNLE
Middle Name:
Last Name:OLATUNJI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 LINDEN ST APT J2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-7976
Mailing Address - Country:US
Mailing Address - Phone:347-484-6016
Mailing Address - Fax:
Practice Address - Street 1:93 LINDEN ST APT J2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-7976
Practice Address - Country:US
Practice Address - Phone:347-484-6016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator