Individual
SAMSON ADEBOWALE LAWAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
130 09 SPRINGFIELD BLVD, JAMAICA, NY 11413
(718) 712-2003
Mailing address
22214 131ST AVE, SPRINGFIELD GARDENS, NY 11413-1605
(516) 304-8954
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
249939209
—
NY
Enumeration date
12/08/2022
Last updated
12/08/2022
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