Individual
ABEEB BALOGUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4506 64TH ST APT 3L, WOODSIDE, NY 11377-5779
(443) 600-0562
Mailing address
4506 64TH ST APT 3L, WOODSIDE, NY 11377-5779
(443) 600-0562
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
967191
NY
164W00000X
Licensed Practical Nurse
Primary
345526
NY
Other
Enumeration date
02/01/2023
Last updated
04/02/2026
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