Provider Demographics
NPI:1528215985
Name:EDUKUYE, DANIEL ESEOGHENE (RN)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:ESEOGHENE
Last Name:EDUKUYE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12219 BENTON ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413-1052
Mailing Address - Country:US
Mailing Address - Phone:678-551-4358
Mailing Address - Fax:
Practice Address - Street 1:12219 BENTON ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11413-1052
Practice Address - Country:US
Practice Address - Phone:678-551-4358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287565164W00000X
NY717716163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No163W00000XNursing Service ProvidersRegistered Nurse