Provider Demographics
NPI:1205156395
Name:AFONJA, HUMU SANUSI
Entity type:Individual
Prefix:
First Name:HUMU
Middle Name:SANUSI
Last Name:AFONJA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169-33 144 ROAD
Mailing Address - Street 2:SWEET P. HOME CARE INC.
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11434
Mailing Address - Country:US
Mailing Address - Phone:718-978-7221
Mailing Address - Fax:718-978-0032
Practice Address - Street 1:169-33 144 ROAD
Practice Address - Street 2:SWEET P. HOME CARE INC.
Practice Address - City:SPRINGFIELD GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11434
Practice Address - Country:US
Practice Address - Phone:718-978-7221
Practice Address - Fax:718-978-0032
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY294040-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse