Provider Demographics
NPI:1487232047
Name:OBI, MUKOSOLU FLORENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:MUKOSOLU
Middle Name:FLORENCE
Last Name:OBI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1562 E 98TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-5514
Mailing Address - Country:US
Mailing Address - Phone:504-327-8237
Mailing Address - Fax:
Practice Address - Street 1:1562 E 98TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-5514
Practice Address - Country:US
Practice Address - Phone:504-327-8237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program