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General NPI Number Information
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NPI Number | 1710820964
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Entity Type | Individual
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Provider Name | NNAMDI OLISAH
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Gender | Male
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Dates
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Enumeration Date | 04/13/2026
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Last Update Date | 04/13/2026
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Provider Practice Location Address
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Address Line | 1104 BEDFORD AVE
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City | BROOKLYN
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State | NY
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Zip | 11216-6591
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Country | US
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Telephone | 718-874-9322
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Fax | 718-874-9323
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Provider Business Mailing Address
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Address Line | 217 E 7TH ST APT 6C
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City | BROOKLYN
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State | NY
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Zip | 11218-2631
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Country | US
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Telephone | 718-578-3046
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 055568
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License Number State | NY
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