Individual
ADESOLA AHMED AGBOOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2200 NORTHERN BLVD, SUITE 104, LONG ISLAND, NY 11548
(516) 304-7234
Mailing address
2200 NORTHERN BLVD, SUITE 104, LONG ISLAND, NY 11548
(516) 304-7234
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/14/2024
Last updated
05/14/2024
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