Provider Demographics
NPI:1639946213
Name:HURDLE, OLUBUKOLA EVELYN (REGISTERED PHARMACIS)
Entity Type:Individual
Prefix:
First Name:OLUBUKOLA
Middle Name:EVELYN
Last Name:HURDLE
Suffix:
Gender:F
Credentials:REGISTERED PHARMACIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 DAVIS CT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-1653
Mailing Address - Country:US
Mailing Address - Phone:631-829-4668
Mailing Address - Fax:
Practice Address - Street 1:810 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-3616
Practice Address - Country:US
Practice Address - Phone:862-236-1348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04347600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist