Organization
O.B. ADULT HEALTH NURSE PRACTITIONER SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLASUNKANMI BHADMUS NURSE PRACTITIONER (ASSISTANT DIRECTOR)
(917) 374-9180
Entity
Organization
Contact information
Practice address
209 BROAD ST, STATEN ISLAND, NY 10304-2105
(917) 374-9180
(718) 448-7263
Mailing address
224 OSGOOD AVE, STATEN ISLAND, NY 10304-3607
(718) 448-7263
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
F307489
NY
363LA2200X
Adult Health Nurse Practitioner
F307489
NY
364SG0600X
Gerontology Clinical Nurse Specialist
573342
NY
Other
Enumeration date
10/13/2017
Last updated
11/02/2018
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