Ajibade, Mary Okan

Ajibade, Mary Okan is an sole proprietor health care provider with primary practice located at 81 Park Hill Cir , Staten Island NY 10304-3634. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Ajibade, Mary Okan can be contacted via phone (917) 862-5215.

Contact Information

Primary practice address
81 Park Hill Cir Staten Island NY 10304-3634
Phone: (917) 862-5215
Fax: (718) 347-4643
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 280753 New York

Profile Details

NPI number 1104964212
LBN Legal business name Ajibade, Mary Okan
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2007
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104964212 NPPES
New York MEDICAID 02749026

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