Healthcare Provider Details

I. General information

NPI: 1750734083
Provider Name (Legal Business Name): BLESSING OWOEYE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2016
Last Update Date: 07/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16812 127TH AVE APT # 6A
JAMAICA NY
11434-3152
US

IV. Provider business mailing address

16812 127TH AVE APT # 6A
JAMAICA NY
11434-3152
US

V. Phone/Fax

Practice location:
  • Phone: 718-734-7046
  • Fax:
Mailing address:
  • Phone: 718-734-7046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: