Provider Demographics
NPI:1417218561
Name:AFOLABI, OLUBUKOLA VICTORIA (MSED)
Entity Type:Individual
Prefix:
First Name:OLUBUKOLA
Middle Name:VICTORIA
Last Name:AFOLABI
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-5039
Mailing Address - Country:US
Mailing Address - Phone:718-761-7581
Mailing Address - Fax:
Practice Address - Street 1:36 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5039
Practice Address - Country:US
Practice Address - Phone:718-761-7581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist