=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750091039
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BLESSING OPEYEMI HUNSU R.PH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/28/2022
-----------------------------------------------------
Last Update Date | 11/28/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 209 MOUNT ZOAR ST
-----------------------------------------------------
City | ELMIRA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14904-1231
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 607-733-5636
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 207 S LODER AVE APT A2
-----------------------------------------------------
City | ENDICOTT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13760-4828
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-395-2797
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 069917
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------