Provider Demographics
NPI:1770928350
Name:OBAWEYA, ESTHER
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:OBAWEYA
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 1:735 LINCOLN AVE
Mailing Address - Street 2:5N
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:735 LINCOLN AVE
Practice Address - Street 2:SUITE 5N
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208
Practice Address - Country:US
Practice Address - Phone:347-777-5061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies