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1538717103
ETINOSA OTAGHO
NEW HYDE PARK, NY
NPI
1538717103
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
Enumeration Date
2019-08-27
Last Update Date
2019-08-27
Business Address
ETINOSA OTAGHO
27005 76TH AVE
NEW HYDE PARK, NY 11040-1496
Phone number: 718-470-7000
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Mailing Address
ETINOSA OTAGHO
21711 130TH AVE
SPRINGFIELD GARDENS, NY 11413-1204
Phone number:
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