Provider Demographics
NPI:1700230505
Name:AKINTOLA, AMINAT ADETOUN
Entity Type:Individual
Prefix:
First Name:AMINAT
Middle Name:ADETOUN
Last Name:AKINTOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMINAT
Other - Middle Name:ADETOUN
Other - Last Name:AKINTOLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, FNP
Mailing Address - Street 1:451 CLARKSON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2054
Mailing Address - Country:US
Mailing Address - Phone:718-685-8737
Mailing Address - Fax:347-365-4230
Practice Address - Street 1:796A SARATOGA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-4444
Practice Address - Country:US
Practice Address - Phone:718-685-8737
Practice Address - Fax:347-365-4230
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-18
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY685059163WH0200X, 163WP2201X
NY343699363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care