Individual
BUSOLA RUTH ADEBIYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED PRACTICAL N
Contact information
Practice address
263 BLUE POINT AVE, BLUE POINT, NY 11715-1224
(631) 419-6737
(631) 868-3498
Mailing address
20015 HOLLIS AVE, SAINT ALBANS, NY 11412-1711
(646) 836-0279
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
342433-01
NY
Other
Enumeration date
10/14/2021
Last updated
10/14/2021
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