MEDICARE: SUNDAY IMMANUEL OGUNRINDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1376700104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNDAY IMMANUEL OGUNRINDE

Provider Business Mailing Address
First Line	:	1329 BEACH CHANNEL DR
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-3211
Country	:	US
Telephone Number	:	718-337-6850
Fax Number	:

Provider Business Practice Location Address
First Line	:	141 BEACH 56TH PL
Second Line	:	# 801
City	:	ARVERNE
State	:	NY
Zip	:	11692-1922
Country	:	US
Telephone Number	:	718-474-6050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2008
Last Update Date	:	05/20/2008

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