Organization
EMPIRE ACO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ABIOLA FAMILUSI MD (COO)
(347) 985-0804
Entity
Organization
Contact information
Practice address
1545 ATLANTIC AVE STE 108, BROOKLYN, NY 11213-1122
(347) 985-0804
Mailing address
80 N FRANKLIN ST, HEMPSTEAD, NY 11550-3049
(347) 985-0804
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
04/30/2018
Last updated
04/30/2018
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