Provider Demographics
NPI:1508454307
Name:FOLAMI, IDRIS
Entity Type:Individual
Prefix:
First Name:IDRIS
Middle Name:
Last Name:FOLAMI
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 1:1702 TOPPING AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-7970
Mailing Address - Country:US
Mailing Address - Phone:929-291-9495
Mailing Address - Fax:
Practice Address - Street 1:1702 TOPPING AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7970
Practice Address - Country:US
Practice Address - Phone:929-291-9495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport