Provider Demographics
NPI:1104236009
Name:KARUNWI, BABATUNDE
Entity type:Individual
Prefix:
First Name:BABATUNDE
Middle Name:
Last Name:KARUNWI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 BEACH 57TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1645
Mailing Address - Country:US
Mailing Address - Phone:347-892-0216
Mailing Address - Fax:
Practice Address - Street 1:325 BEACH 57TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11692-1645
Practice Address - Country:US
Practice Address - Phone:347-892-0216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302211-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse