Provider Demographics
NPI:1740585777
Name:SAKA, ADEKUNLE (LPN/RN)
Entity Type:Individual
Prefix:
First Name:ADEKUNLE
Middle Name:
Last Name:SAKA
Suffix:
Gender:M
Credentials:LPN/RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 LENOX AVE
Mailing Address - Street 2:5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-2589
Mailing Address - Country:US
Mailing Address - Phone:718-666-1754
Mailing Address - Fax:
Practice Address - Street 1:111 LENOX AVE
Practice Address - Street 2:5A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-2589
Practice Address - Country:US
Practice Address - Phone:718-666-1754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-23
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290844164W00000X
NY647316163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse