NPI | 1598133399 |
---|---|
Entity Type | Organization |
Authorized Contact | OMOLARA OLANIYI Owner 347-356-4434 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY F333974-1) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
Enumeration Date | 2015-09-10 |
Last Update Date | 2018-04-10 |