Individual
ADETOUN FAJOLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 FARMINGDALE ROAD, WEST BABYLON, NY 11704
(631) 669-5355
Mailing address
62 MARYLAND AVE, FREEPORT, NY 11520-2030
(516) 503-0947
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
699291-01
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F405956-01
NY
Other
Enumeration date
09/27/2022
Last updated
01/30/2025
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