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General NPI Number Information
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NPI Number | 1346074911
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Entity Type | Individual
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Provider Name | OLADUNNI IDOWU
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Gender | Female
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Dates
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Enumeration Date | 08/27/2024
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 1587 BRAYTON POINT RD
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City | SOMERSET
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State | MA
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Zip | 02725-2337
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Country | US
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Telephone | 508-673-9691
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Fax | 508-324-4107
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Provider Business Mailing Address
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Address Line | 11 NEWCOMB ST APT A
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City | PROVIDENCE
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State | RI
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Zip | 02908-2589
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Country | US
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Telephone | 401-440-4197
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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 | PH234462
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License Number State | MA
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