Provider Demographics
NPI:1528399367
Name:LAWAL, HABEEBAT A (RN)
Entity Type:Individual
Prefix:MISS
First Name:HABEEBAT
Middle Name:A
Last Name:LAWAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 ROCKAWAY AVE APT 22A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-4222
Mailing Address - Country:US
Mailing Address - Phone:718-915-7317
Mailing Address - Fax:
Practice Address - Street 1:216 ROCKAWAY AVE APT 22A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-4222
Practice Address - Country:US
Practice Address - Phone:718-915-7317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-19
Last Update Date:2020-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY621302163W00000X
NY309979363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse