Provider Demographics
NPI:1922588953
Name:BANJOKO, ABIODUN (RPH)
Entity Type:Individual
Prefix:DR
First Name:ABIODUN
Middle Name:
Last Name:BANJOKO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 ELDERT LN APT 16P
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-4244
Mailing Address - Country:US
Mailing Address - Phone:917-250-8347
Mailing Address - Fax:
Practice Address - Street 1:2620 HOYT AVE S
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2870
Practice Address - Country:US
Practice Address - Phone:347-507-1608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064190183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist