Olusegun J Bosede, LPN
Licensed Practical Nurse in Central Islip, NY. Individual provider (NPI-1).
NPI number1598082091
StatusActive
Last updated in NPPESApr 23, 2010
Details
- NPI
- 1598082091
- Entity type
- Individual (NPI-1)
- Name
- Mr. Olusegun J Bosede
- Credential
- LPN
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 23, 2010
- Last updated
- Apr 23, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 290933-1 | NY | Yes |
Practice location
217 Hawthorne AveApt 8
Central Islip, NY 11722-1306
Phone 347-891-5231
Mailing address
217 Hawthorne AveCentral Islip, NY 11722-1306
Phone 347-891-5231
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