Provider Demographics
NPI:1609299239
Name:SHOKEYE, OLUWATOSIN
Entity Type:Individual
Prefix:
First Name:OLUWATOSIN
Middle Name:
Last Name:SHOKEYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 PARK HILL AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-4822
Mailing Address - Country:US
Mailing Address - Phone:347-280-4817
Mailing Address - Fax:
Practice Address - Street 1:121A WEST 20TH STREET
Practice Address - Street 2:VILLAGE DIAGNOSTIC & TREATMENT CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:212-337-9290
Practice Address - Fax:212-337-9275
Is Sole Proprietor?:No
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY337894363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily