Provider Demographics
NPI:1184900300
Name:FADOJU, AKINTAYO OLALEKAN (RN, NP)
Entity type:Individual
Prefix:MR
First Name:AKINTAYO
Middle Name:OLALEKAN
Last Name:FADOJU
Suffix:
Gender:M
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 SCHENCK AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-9108
Mailing Address - Country:US
Mailing Address - Phone:845-709-4914
Mailing Address - Fax:646-417-7811
Practice Address - Street 1:1 WHITEHALL ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-2109
Practice Address - Country:US
Practice Address - Phone:646-717-6101
Practice Address - Fax:646-417-7811
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345166363LF0000X
NY618967163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse