Individual
FISAYO OGUNYOMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
13727 246TH ST, ROSEDALE, NY 11422-1838
(917) 880-0579
Mailing address
13727 246TH ST, ROSEDALE, NY 11422-1838
(917) 880-0579
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F341006-1
NY
Other
Enumeration date
08/24/2016
Last updated
08/24/2016
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