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Individual

OLUWABUKOLA FABA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3139
(917) 407-1383
Mailing address
77 GARNET PL, ELMONT, NY 11003-3633
(917) 407-1383

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
685259
NY
363L00000X
Nurse Practitioner
Primary
F309178-01
NY

Other

Enumeration date
06/13/2014
Last updated
12/16/2019
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