Provider Demographics
NPI:1801566005
Name:DUROSOGA, OLUWASEYE T (RN)
Entity type:Individual
Prefix:
First Name:OLUWASEYE
Middle Name:T
Last Name:DUROSOGA
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 1:45 PAERDEGAT 3RD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4133
Mailing Address - Country:US
Mailing Address - Phone:718-581-7664
Mailing Address - Fax:
Practice Address - Street 1:45 PAERDEGAT 3RD ST APT 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4133
Practice Address - Country:US
Practice Address - Phone:718-581-7664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-18
Last Update Date:2021-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7844689163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse