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General NPI Number Information
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NPI Number | 1437968039
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Entity Type | Organization
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Legal Business Name | NUEBAC LLC
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 523 E 72ND ST FL 3
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City | NEW YORK
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State | NY
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Zip | 10021-4099
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Country | US
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Telephone | 646-797-8500
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Fax | 917-260-4565
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Provider Business Mailing Address
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Address Line | 523 E 72ND ST FL 3
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City | NEW YORK
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State | NY
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Zip | 10021-4099
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Country | US
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Telephone | 646-797-8500
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Fax | 917-260-4565
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Authorized Official
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Title or Position | ORTHOPEDIC SPINE SURGEON
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Name | GBOLABO SOKUNBI
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Credential | MD
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Telephone | 732-690-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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