Individual
BOLAJI BANKOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
355 BARD AVE, STATEN ISLAND, NY 10310-1664
(718) 818-1234
Mailing address
355 BARD AVE, STATEN ISLAND, NY 10310-1664
(718) 818-1234
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA09771800
NJ
Other
Enumeration date
01/05/2013
Last updated
04/17/2016
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