Provider Demographics
NPI:1023319977
Name:OGUNYEMI, FELICIA OLUBUNMI (DNP, PMHNP, FNP)
Entity type:Individual
Prefix:DR
First Name:FELICIA
Middle Name:OLUBUNMI
Last Name:OGUNYEMI
Suffix:
Gender:F
Credentials:DNP, PMHNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1176 E 86TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4737
Mailing Address - Country:US
Mailing Address - Phone:347-512-3448
Mailing Address - Fax:
Practice Address - Street 1:1176 E 86TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4737
Practice Address - Country:US
Practice Address - Phone:347-512-3448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-09
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337579-01363LF0000X
NYF406302-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily