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Individual

MR. ADETOKUNBO TOLULOPE ADEWETAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2 ROOSEVELT AVE STE 300, SYOSSET, NY 11791-3064
(516) 496-4460
(516) 921-4432
Mailing address
1637 SAINT MARKS AVE APT 4R, BROOKLYN, NY 11233-4839
(917) 651-8893

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
SA68500N
NY
Enumeration date
07/30/2013
Last updated
09/25/2013
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