Provider Demographics
NPI:1376700104
Name:OGUNRINDE, SUNDAY IMMANUEL
Entity Type:Individual
Prefix:
First Name:SUNDAY
Middle Name:IMMANUEL
Last Name:OGUNRINDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 BEACH CHANNEL DR
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-3211
Mailing Address - Country:US
Mailing Address - Phone:718-337-6850
Mailing Address - Fax:
Practice Address - Street 1:141 BEACH 56TH PL
Practice Address - Street 2:# 801
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-1922
Practice Address - Country:US
Practice Address - Phone:718-474-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional