Individual
BISOLA OMOTADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
969 CRESCENT ST FL 2, BROOKLYN, NY 11208-5517
(347) 789-3057
Mailing address
969 CRESCENT ST APT 2, BROOKLYN, NY 11208-5539
(347) 789-3057
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
593920
NY
Other
Enumeration date
06/28/2010
Last updated
10/27/2025
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