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General NPI Number Information
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NPI Number | 1194184630
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Entity Type | Individual
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Provider Name | OLUTOYIN POPOOLA
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Gender | Female
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Dates
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Enumeration Date | 02/11/2016
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Last Update Date | 02/11/2016
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Provider Practice Location Address
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Address Line | 2074 8TH AVE
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City | NEW YORK
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State | NY
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Zip | 10026-3375
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Country | US
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Telephone | 212-222-3653
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Fax |
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Provider Business Mailing Address
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Address Line | 12 CORNERS RD
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City | CONGERS
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State | NY
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Zip | 10920-1222
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Country | US
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Telephone | 845-709-4273
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | I056735-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI03068300
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License Number State | NJ
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