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ADERONKE ASHABI OMOLOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
13318 161ST ST, JAMAICA, NY 11434-2932
(718) 413-2369
Mailing address
13318 161ST ST, JAMAICA, NY 11434-2932
(718) 413-2369

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
300983
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
300983
LICENCE PRACTICAL NURSE
NY
Enumeration date
07/22/2010
Last updated
07/22/2010
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