Organization
OPTIMAL LIFE INTEGRATIVE HEALTH CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YUSUPHA DUKUREH FNP-BC (ADMINISTRATOR)
(347) 849-1576
Entity
Organization
Contact information
Practice address
105 W 125TH ST FRNT 1, NEW YORK, NY 10027-4444
(347) 872-9006
Mailing address
105 W 125TH ST FRNT 1, NEW YORK, NY 10027-4444
(347) 872-9006
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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