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1851648596
OLUBOWALE FASOLA
MOUNT VERNON, NY
NPI
1851648596
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 299582)
Enumeration Date
2012-08-13
Last Update Date
2015-07-02
Business Address
-- OLUBOWALE FASOLA LPN
9 W PROSPECT AVE STE 310
MOUNT VERNON, NY 10550-2049
Phone number: 914-699-0022
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Mailing Address
-- OLUBOWALE FASOLA LPN
9 W PROSPECT AVE STE 310
MOUNT VERNON, NY 10550-2049
Phone number: 914-699-0022
Copy
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