Odusanwo, Olatunji Abiodun

Odusanwo, Olatunji Abiodun is an individual health care provider with primary practice located at 465 New Dorp Ln , Staten Island NY 10306-4902. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Odusanwo, Olatunji Abiodun can be contacted via phone (718) 987-0128.

Contact Information

Primary practice address
465 New Dorp Ln Staten Island NY 10306-4902
Phone: (718) 987-0128
Fax: (718) 987-0223
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 057740 New York
Behavioral Health & Social Service Providers / School 1041S0200X 057740 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X 057740 New York

Profile Details

NPI number 1013979897
LBN Legal business name Odusanwo, Olatunji Abiodun
Credentials LCSW-R
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated Aug 25th, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013979897 NPPES
New York MEDICAID 02167866

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