Organization
ROCKAWAY KIDNEY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLUSEGUN OGUNFOWORA MD (MD)
(516) 770-5712
Entity
Organization
Contact information
Practice address
529 BEACH 20TH ST, FAR ROCKAWAY, NY 11691-3645
(516) 770-5712
(718) 228-8036
Mailing address
529 BEACH 20TH ST, FAR ROCKAWAY, NY 11691-3645
(516) 770-5712
(718) 228-8036
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
07/27/2016
Last updated
07/27/2016
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