OMOTAYO FAKORODE

STATEN ISLAND, NY
NPI1902108269
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy163W00000X Registered Nurse
(Licence: NY  648044)
Additional Taxonomies164W00000X Licensed Practical Nurse
(Licence: NY  263598)
Enumeration Date2010-11-18
Last Update Date2012-07-30
Business Address
-- OMOTAYO FAKORODE
77 FRASER ST
STATEN ISLAND, NY 10314-6111
Phone number: 718-664-3438
Mailing Address
-- OMOTAYO FAKORODE
77 FRASER ST
STATEN ISLAND, NY 10314-6111
Phone number: 718-664-3438