Provider Demographics
NPI:1386956654
Name:POROYE, AFOLABI (FNP-BC)
Entity type:Individual
Prefix:
First Name:AFOLABI
Middle Name:
Last Name:POROYE
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6226 BURCHELL RD
Mailing Address - Street 2:BOX 5
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1343
Mailing Address - Country:US
Mailing Address - Phone:347-469-9341
Mailing Address - Fax:347-727-7399
Practice Address - Street 1:6226 BURCHELL RD
Practice Address - Street 2:BOX 5
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-1343
Practice Address - Country:US
Practice Address - Phone:347-469-9341
Practice Address - Fax:347-727-7399
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-02
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336516-1364SF0001X
NY596466-1163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice