Individual
DR. ALUKO OSAFO JERVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M
Contact information
Practice address
295 MYRTLE AVE, STATEN ISLAND, NY 10310-2332
(718) 720-6866
(718) 720-6931
Mailing address
295 MYRTLE AVE, STATEN ISLAND, NY 10310-2332
(718) 273-2984
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
N006185-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N006185-1
LICENSE NUMBER
NY
Enumeration date
12/26/2006
Last updated
02/07/2019
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