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1770819583
MODUPE ADEWALE
STATEN ISLAND, NY
NPI
1770819583
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 288757)
Enumeration Date
2009-10-29
Last Update Date
2009-10-29
Business Address
-- MODUPE ADEWALE LPN
1477 HYLAN BLVD
STATEN ISLAND, NY 10305-1906
Phone number: 718-979-6900
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Mailing Address
-- MODUPE ADEWALE LPN
33 POND WAY
STATEN ISLAND, NY 10303-1600
Phone number: 718-688-1035
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