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Individual

AWOSELY JACOB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2041 ELK DR, FAR ROCKAWAY, NY 11691-3613
(929) 338-2412
Mailing address
2041 ELK DR, FAR ROCKAWAY, NY 11691-3613
(929) 338-2412

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Enumeration date
04/25/2023
Last updated
04/25/2023
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