Balogun, Adewale Mark

Balogun, Adewale Mark is an sole proprietor health care provider with primary practice located at 49 Grasslands Cir , Mount Sinai NY 11766-1856. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Licensed Practical Nurse, Nursing Service Providers / General Practice. Nursing Service Providers / General Practice is his primary health care specialty. Balogun, Adewale Mark can be contacted via phone (631) 897-8498.

Contact Information

Primary practice address
49 Grasslands Cir Mount Sinai NY 11766-1856
Phone: (631) 897-8498
Fax: (631) 666-1601
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 2583711 New York
Nursing Service Providers / General Practice 163WG0000X 642609-1 New York

Profile Details

NPI number 1457425613
LBN Legal business name Balogun, Adewale Mark
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 20th, 2006
Last updated Sep 29th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457425613 NPPES
New York MEDICAID 02151077

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