Individual
NKOLI VANESSA AKAOLISA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.S.
Contact information
Practice address
68 S SERVICE RD STE 350, MELVILLE, NY 11747-2358
(315) 413-5229
Mailing address
PO BOX 275, GLEN HEAD, NY 11545-0275
(315) 413-5229
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036157775
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2017
Last updated
08/07/2021
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