Individual provider · NPI-1

Memoudou Abalola, NP

Nurse Practitioner, Family · Bronx, NY

NPI number1154580520
StatusActive
Last updated in NPPESOct 10, 2020

Details

NPI
1154580520
Entity type
Individual (NPI-1)
Name
Mr. Memoudou Abalola
Credential
NP
Sex
Male
Sole proprietor
No
Enumeration date
Jun 2, 2008
Certification date
Oct 10, 2020
Last updated
Oct 10, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyF335376NYYes

Practice location

2015 Grand Concourse
Bronx, NY 10453-4303

Phone 718-299-7295 · Fax 718-299-6797

Mailing address

1434 Williamsbridge Rd Fl 2
Bronx, NY 10461-2507

Phone 718-618-0401 · Fax 347-479-1303

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