Provider Demographics
NPI:1851616320
Name:FALANA, JAMES OLANREWAJU (LPN)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:OLANREWAJU
Last Name:FALANA
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 ELGAR PL APT 3M
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-5273
Mailing Address - Country:US
Mailing Address - Phone:347-351-4192
Mailing Address - Fax:347-202-8127
Practice Address - Street 1:140 ELGAR PL APT 3M
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-5273
Practice Address - Country:US
Practice Address - Phone:347-351-4192
Practice Address - Fax:347-202-8127
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-28
Last Update Date:2010-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY300602164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY$$$$$$$$$Medicaid