Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Adetoun Fajolu

Individual provider Registered Nurse · NPI 1205550027

Adetoun Fajolu is a Nurse Practitioner in West Babylon, New York. Qualified in 2024, 2 years ago. Practices with Positive Change Psychiatry PLLC, a 6-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
2
Licensed in
NY
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

1 Farmingdale Rd
West Babylon, NY 11704
Phone: (631) 669-5355
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence F405956-01 (NY)
Registered Nurse Taxonomy 163W00000X · Licence 699291-01 (NY)

Record details

NPI number1205550027
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 27, 2022
Last updated in NPPESJanuary 30, 2025
Certification dateJanuary 2, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Positive Change Psychiatry Pllc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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