Healthcare Provider Details

I. General information

NPI: 1891177549
Provider Name (Legal Business Name): KOJO'S PEST ELIMINATION CO., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2015
Last Update Date: 06/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1576 BOSTON RD
BRONX NY
10460-4944
US

IV. Provider business mailing address

1576 BOSTON RD
BRONX NY
10460-4944
US

V. Phone/Fax

Practice location:
  • Phone: 718-861-5656
  • Fax:
Mailing address:
  • Phone: 718-861-5656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number04052
License Number StateNY

VIII. Authorized Official

Name: MR. KOJO AYESU
Title or Position: OWNER
Credential:
Phone: 718-861-5656