Provider Demographics
NPI:1992548309
Name:IYOKHO, ADESUWA JOANNE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:ADESUWA
Middle Name:JOANNE
Last Name:IYOKHO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 COOPER DR
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-4707
Mailing Address - Country:US
Mailing Address - Phone:617-293-5713
Mailing Address - Fax:
Practice Address - Street 1:675 3RD AVE 5TH FLOOR
Practice Address - Street 2:
Practice Address - City:NEW YORK,
Practice Address - State:NY
Practice Address - Zip Code:10017
Practice Address - Country:US
Practice Address - Phone:212-922-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY833768163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health