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1093189029
MODUPE TIJANI
STATEN ISLAND, NY
NPI
1093189029
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 300406-1)
Enumeration Date
2015-11-13
Last Update Date
2015-11-13
Business Address
-- MODUPE TIJANI
345 VAN NAME AVE
STATEN ISLAND, NY 10303-2526
Phone number: 718-815-0906
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Mailing Address
-- MODUPE TIJANI
345 VAN NAME AVE
STATEN ISLAND, NY 10303-2526
Phone number: 718-815-0906
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