Individual
EMIOLA OMOLOLA ADEGBITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
135 FILLMORE AVE, DEER PARK, NY 11729-7003
(516) 984-8347
(718) 327-3294
Mailing address
6915 HILLMEYER AVE, ARVERNE, NY 11692-1121
(516) 984-8347
(718) 327-3294
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
021492-1
NY
Other
Enumeration date
02/06/2007
Last updated
12/15/2008
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