Provider Demographics
NPI:1609067719
Name:APALARA, JELILI ATINUSOLA (MD, MPH, FRIPH)
Entity Type:Individual
Prefix:DR
First Name:JELILI
Middle Name:ATINUSOLA
Last Name:APALARA
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Gender:M
Credentials:MD, MPH, FRIPH
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Mailing Address - Street 1:2027 SEAGIRT BLVD
Mailing Address - Street 2:APT. 2C
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-2920
Mailing Address - Country:US
Mailing Address - Phone:516-998-6037
Mailing Address - Fax:718-869-8530
Practice Address - Street 1:327 BEACH 19TH ST
Practice Address - Street 2:DEPT. OF MEDICINE
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4423
Practice Address - Country:US
Practice Address - Phone:516-998-6037
Practice Address - Fax:718-869-8530
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2008-04-22
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Provider Licenses
StateLicense IDTaxonomies
WI50725207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02593557Medicaid
06330Medicare PIN