Individual
MICHELE AWOBULUYI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
153 W 11TH ST, NEW YORK, NY 10011-8305
(212) 604-2416
Mailing address
350 W 43RD ST, APT 35B, NEW YORK, NY 10036-6454
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
191625
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1906358
—
NY
Enumeration date
06/25/2006
Last updated
02/01/2016
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