Provider Demographics
NPI:1013241223
Name:OJEYEMI, TOLULOPE DAMILOLA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:TOLULOPE
Middle Name:DAMILOLA
Last Name:OJEYEMI
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Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:55 WATER STREET
Mailing Address - Street 2:2ND FLOOR CRED DEPT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10041-0010
Mailing Address - Country:US
Mailing Address - Phone:646-680-2888
Mailing Address - Fax:516-542-5556
Practice Address - Street 1:447 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-1702
Practice Address - Country:US
Practice Address - Phone:718-858-6300
Practice Address - Fax:718-858-0145
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2022-11-30
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Provider Licenses
StateLicense IDTaxonomies
CA95008358363LF0000X
NYF335437-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03191999Medicaid