Individual
BASSEY ULO ENYENIHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
287 WADING RIVER ROAD, SUITE 8, MANORVILLE, NY 11949-1194
(631) 716-5410
Mailing address
17 BIRCHGROVE DR, CENTRAL ISLIP, NY 11722-1904
(516) 983-0893
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F343092-1
NY
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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