Individual
BARAQAT ADEWOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2052 TILLOTSON AVE, BRONX, NY 10475-1560
(718) 671-2100
Mailing address
85 W BURNSIDE AVE, BRONX, NY 10453-4015
(718) 716-4400
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
342303
NY
Other
Enumeration date
03/20/2013
Last updated
02/20/2019
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