Individual
MS. ADAUGO IWUALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
630 W 168TH ST, NEW YORK, NY 10032-3725
(212) 305-2500
Mailing address
7123 BUCHANAN ST, LANDOVER HILLS, MD 20784-2131
(240) 422-7735
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027397
LICENSE
NY
Enumeration date
09/28/2021
Last updated
09/09/2022
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