Individual
MR. ADETOKUNBO AJIBULU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
11949 UNION TPKE, APT # 5D, FOREST HILLS, NY 11375-6151
(646) 321-6197
Mailing address
374 STOCKHOLM ST, C/O FACULTY PRACTICE MANAGEMENT SUITE I-37 NORTH, BROOKLYN, NY 11237-4006
(718) 963-6551
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
010505
NY
363AM0700X
Medical Physician Assistant
—
VA
Other
Enumeration date
08/13/2006
Last updated
02/01/2008
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