Individual
AISABOMEN MUSA-AGBONENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
260 BROADWAY, BROOKLYN, NY 11211-8433
(540) 849-5152
Mailing address
350 VANDERBILT AVE, STATEN ISLAND, NY 10304-3570
(347) 788-8216
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
100867-1
NY
1041C0700X
Clinical Social Worker
Primary
101524-01
NY
Other
Enumeration date
10/31/2018
Last updated
11/29/2025
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