Individual provider · NPI-1

Omolara Rachael Adediji, RN, MSN, FNP

Nurse Practitioner, Family · Staten Island, NY

NPI number1275059321
StatusActive
Last updated in NPPESJul 21, 2022

Details

NPI
1275059321
Entity type
Individual (NPI-1)
Name
Mrs. Omolara Rachael Adediji
Credential
RN, MSN, FNP
Sex
Female
Sole proprietor
Yes
Enumeration date
Aug 21, 2017
Last updated
Jul 21, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family340336NYYes

Practice location

210 Trantor Place
Apt 1d
Staten Island, NY 10302

Phone 646-353-2238

Mailing address

210 Trantor Pl Apt 1d
Staten Island, NY 10302-1974

Phone 646-353-2238

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