Individual
AKINWALE OGUNTUASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
530 BOLTON AVE, BRONX, NY 10473-2902
(347) 993-2186
Mailing address
530 BOLTON AVE, BRONX, NY 10473-2902
(347) 993-2186
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
316559-1
NY
Other
Enumeration date
11/01/2013
Last updated
11/01/2013
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