Jessica Obidimalor
Nurse Practitioner - Adult Health
165-17 145th Road
Jamaica
, New York 11434
Jessica Obidimalor
Nurse Practitioner - Adult Health
165-17 145th Road
Jamaica
, New York 11434
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About
Features
Specialties
- Nurse Practitioner - Adult Health
Languages spoken
- English
Location
First Address
- Jessica Obidimalor
- 165-17 145th Road
- Jamaica, NY
- Zip : 11434
- Phone :
Second Address
- Jessica Obidimalor
- 165-17 145th Road
- Jamaica, NY
- Zip : 11434
- Phone : (347) 570-5153
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LA2200X | Nurse Practitioner - Adult Health | 309587 | NY |
National Provider Identifier
| NPI | 1023635430 |
|---|---|
| Provider Name | Jessica Obidimalor |
| First Address | Jamaica, NY 11434 |
| Second Address | Jamaica, NY 11434 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/07/2020 |
| Last Update Date | 01/07/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.