Fagbenle, Olasupo
Fagbenle, Olasupo is an sole proprietor health care provider with primary practice located at 18636 Jordan Ave , Saint Albans NY 11412-2308. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Fagbenle, Olasupo can be contacted via phone (917) 605-3771.Contact Information
Primary practice address
18636 Jordan Ave
Saint Albans NY 11412-2308
Phone: (917) 605-3771
Fax: (718) 264-7797
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | P48013 | New York |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 8744914 | New York |
Profile Details
| NPI number | 1982770079 |
|---|---|
| LBN Legal business name | Fagbenle, Olasupo |
| Credentials | LMSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 28th, 2006 |
| Last updated | Jan 5th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982770079 | NPPES |
| New York | Other | 8744914 | THE UNIVERSITY OF THE STATE OF NEW YORK, EDUCATION DEPARTMENT |
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