Individual
JESSICA OBIDIMALOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
165-17 145TH ROAD, JAMAICA, NY 11434
(347) 570-5153
Mailing address
165-17 145TH ROAD, JAMAICA, NY 11434
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
309587
NY
Other
Enumeration date
07/01/2020
Last updated
07/01/2020
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