Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | F401162-1 | NY |
NPI | 1013160613 |
---|---|
Provider Name | Mrs. Bolanle Olajumoke Bello |
First Address | Bronx, NY 10470-1407 |
Second Address | Bronx, NY 10470-1407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2008 |
Last Update Date | 28/10/2008 |