Organization
WOUND PROS NEW YORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER AYODELE OTIKO MD (PRESIDENT)
(818) 836-2475
Entity
Organization
Contact information
Practice address
400 WHITE SPRUCE BLVD STE 134, BRIGHTON, NY 14623
(323) 545-3676
(323) 433-9177
Mailing address
4640 ADMIRALTY WAY STE 500, MARINA DEL REY, CA 90292-6636
(818) 836-2475
(323) 433-9177
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
12/13/2019
Last updated
05/23/2022
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