Provider Demographics
NPI:1245560341
Name:ONAKOMAYA, ADEYINKA (NURSE)
Entity Type:Individual
Prefix:
First Name:ADEYINKA
Middle Name:
Last Name:ONAKOMAYA
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 SHAINA CT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10303-2735
Mailing Address - Country:US
Mailing Address - Phone:917-753-4049
Mailing Address - Fax:
Practice Address - Street 1:27 SHAINA CT
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10303-2735
Practice Address - Country:US
Practice Address - Phone:917-753-4049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6098146164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse