Provider Demographics
NPI:1780963223
Name:ADEMOLA, OLUFUNMILOLA YETUNDE (CNM)
Entity type:Individual
Prefix:MRS
First Name:OLUFUNMILOLA
Middle Name:YETUNDE
Last Name:ADEMOLA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13747 234TH ST
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-1702
Mailing Address - Country:US
Mailing Address - Phone:718-977-2784
Mailing Address - Fax:718-977-2784
Practice Address - Street 1:13747 234TH ST
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-1702
Practice Address - Country:US
Practice Address - Phone:718-977-2784
Practice Address - Fax:718-977-2784
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF001441176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife