Individual
ADENIKE IDOWU DAVID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16937 144TH RD, JAMAICA, NY 11434-5929
(718) 614-9390
Mailing address
21 NORTHFIELD AVE, STATEN ISLAND, NY 10303-1624
(718) 614-9390
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
276243
NY
Other
Enumeration date
02/09/2010
Last updated
02/09/2010
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