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General NPI Number Information
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NPI Number | 1588428064
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Entity Type | Individual
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Provider Name | ANDREW KUFORIJI
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Gender | Male
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Dates
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Enumeration Date | 02/06/2024
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 8 CARL PL
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City | NEW WINDSOR
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State | NY
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Zip | 12553-5952
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Country | US
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Telephone | 929-602-6813
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Fax |
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Provider Business Mailing Address
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Address Line | 2017 FULTON ST APT 2
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City | BROOKLYN
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State | NY
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Zip | 11233-4294
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Country | US
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Telephone | 929-602-6813
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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 | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | RN2277178
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License Number State | MA
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