Individual
MS. LATIFAT OLABISI BAMGBOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
233 LEHIGH AVENUE, #3, NEWARK, NJ 07112
(862) 264-3950
Mailing address
233 LEHIGH AVENUE, #3, NEWARK, NJ 07112
(862) 264-3950
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP07135300
NJ
Other
Enumeration date
01/08/2020
Last updated
01/08/2020
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