| NPI | 1982381877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOLULOPE OLAJUMOKE KOLAWOLE Nurse Practitioner 718-200-5446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2024-09-17 |