# OPTIMAL LIFE INTEGRATIVE HEALTH CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386475465
- **Authorized official:** DR. YUSUPHA DUKUREH FNP-BC (ADMINISTRATOR)
- **Authorized official phone:** (347) 849-1576

## Contact information

- **Practice address:** 105 W 125TH ST FRNT 1, NEW YORK, NY 10027-4444
- **Practice address phone:** (347) 872-9006
- **Mailing address:** 105 W 125TH ST FRNT 1, NEW YORK, NY 10027-4444
- **Mailing address phone:** (347) 872-9006

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/12/2024
- **Last updated:** 08/12/2024