Provider Demographics
NPI:1932776952
Name:H & O FAMILY AND ADULT HEALTH NURSE PRACTITIONER PLLC
Entity Type:Organization
Organization Name:H & O FAMILY AND ADULT HEALTH NURSE PRACTITIONER PLLC
Other - Org Name:H & O CLINICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITONER
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:IBITOKUN
Authorized Official - Suffix:
Authorized Official - Credentials:APN, NP
Authorized Official - Phone:908-279-5785
Mailing Address - Street 1:2025 CENTRAL PARK AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-2427
Mailing Address - Country:US
Mailing Address - Phone:315-610-6702
Mailing Address - Fax:315-610-6703
Practice Address - Street 1:2025 CENTRAL PARK AVE STE 203
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-2427
Practice Address - Country:US
Practice Address - Phone:315-610-6702
Practice Address - Fax:315-610-6702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty