Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 199194 | NY |
NPI | 1194719492 |
---|---|
Provider Name | Olubunmi O. Afonja |
First Address | New York, NY 10016-4974 |
Second Address | New York, NY 10016-4974 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01973793 | (05) | NY |
G22407 | (02) | NY |