Individual
ABISOYE OGUNSUSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
121 LAKE ST, BROOKLYN, NY 11223-2734
(212) 719-9600
Mailing address
975 ASHFORD ST, BROOKLYN, NY 11207-8907
(212) 719-9600
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
295947
NY
Other
Enumeration date
09/30/2009
Last updated
09/30/2009
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