Individual
AYOOLA OLADIPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
626 BEACH 65TH ST, ARVERNE, NY 11692-1355
(917) 376-2847
Mailing address
626 BEACH 65TH ST, ARVERNE, NY 11692-1355
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
270538
NY
Other
Enumeration date
12/20/2010
Last updated
12/20/2010
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