Organization
WHITE GLOVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS OTASERE OSAYEMWENRE IZEVBUWA (LPN)
(917) 982-6208
Entity
Organization
Contact information
Practice address
1110 E 214TH ST, BRONX, NY 10469-2412
(917) 982-6208
Mailing address
PO BOX 84, BRONX, NY 10467-0084
(917) 982-6208
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
321731
NY
Other
Enumeration date
04/17/2015
Last updated
04/17/2015
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