MEDICARE: OLUWAGBENGA FILANI RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	309236	NY
2	163W00000X	Registered Nurse	26NR24797100	NJ

General Provider Information

NPI Number	:	1447508353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLUWAGBENGA FILANI RN

Provider Business Mailing Address
First Line	:	67 GARFIELD AVE
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-2329
Country	:	US
Telephone Number	:	917-435-1042
Fax Number	:

Provider Business Practice Location Address
First Line	:	67 GARFIELD AVE
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-2329
Country	:	US
Telephone Number	:	917-435-1042
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2012
Last Update Date	:	09/12/2023

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