Adetokunbo Ajibulu, P.A.
Physician Assistant in Forest Hills, NY. Individual provider (NPI-1).
NPI number1912919044
StatusActive
Last updated in NPPESFeb 1, 2008
Details
- NPI
- 1912919044
- Entity type
- Individual (NPI-1)
- Name
- Mr. Adetokunbo Ajibulu
- Credential
- P.A.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 13, 2006
- Last updated
- Feb 1, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 010505 | NY | Yes |
| 363AM0700X | Physician Assistant, Medical | 010002669 | VA |
Practice location
11949 Union TpkeApt # 5d
Forest Hills, NY 11375-6151
Phone 646-321-6197
Mailing address
374 Stockholm StC/O Faculty Practice Management Suite I-37 North
Brooklyn, NY 11237-4006
Phone 718-963-6551
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All 67 Physician Assistant providers in Forest Hills · All 4,796 providers in Forest Hills
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