Individual
MODUPE BOLANLE ODUGBEMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
214 STEPHENS AVE, BRONX, NY 10473-2424
(917) 691-1219
Mailing address
214 STEPHENS AVE, BRONX, NY 10473-2424
(917) 691-1219
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
F341213-1
NY
Other
Enumeration date
12/06/2016
Last updated
12/06/2016
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