| Doctor Name: | HENRY ADEWOLE IBITOKUN |
| NPI Number: | 1194109744 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | APN-C |
| License Number: | 26NJ00578600 |
| Business Practice Address: | 111 Abbi Rd Carteret, NJ - 070083535 |
| Business Phone Number: | 9082795785 |
| Business Fax Number: | |
| Mailing Address: | 111 Abbi Rd, CARTERET |
| State: | NJ |
| Postal Code: | 070083535 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/14/2015 |
| NPI Last Update Date: | 07/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 26NJ00578600 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |