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ADESHOLA DIRISU LPN
NPI 1164742011
Licensed Practical Nurse in Bay Shore, NY

Active since June 02, 2010
104 PINEBROOK PL, BAY SHORE, NY 11706(631) 647-3757 Get Directions Write a Review

NPPES record last updated: June 2, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Adeshola Dirisu Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADESHOLA DIRISU LPN (NPI 1164742011) is an individual licensed practical nurse in Bay Shore, New York, licensed in New York (290354) and active in the NPI registry since June 2010.

NPPES Registry Identity

NPI1164742011
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameADESHOLA DIRISUCredential: LPN
Location Address104 PINEBROOK PLBay Shore, NY 11706-4457
Mailing Address104 Pinebrook PlBay Shore, NY 11706-4457 · (631) 647-3757
Phone(631) 647-3757
Sole ProprietorYes
Enumeration DateJune 2, 2010
✔ NPI 1164742011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in NY · 290354
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
104 PINEBROOK PL, Bay Shore, NY 11706
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Adeshola Dirisu's NPI number?

The NPI number for Adeshola Dirisu is 1164742011. It was assigned to this individual provider in the NPPES registry on June 2, 2010.

Where is Adeshola Dirisu located?

Adeshola Dirisu practices at 104 Pinebrook Pl, Bay Shore, NY 11706. The listed phone number is (631) 647-3757.

What is Adeshola Dirisu's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Adeshola Dirisu was last updated on June 2, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.