Individual
MR. PETER ADEKOLA FASANYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT,DPT
Contact information
Practice address
91 ELZEY AVE, ELMONT, NY 11003-1532
(718) 736-4632
(516) 352-4548
Mailing address
91 ELZEY AVE, ELMONT, NY 11003-1532
(718) 736-4632
(516) 352-4548
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
027197
NY
Other
Enumeration date
10/07/2008
Last updated
10/07/2008
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