Provider Demographics
NPI:1124201959
Name:OGUNDIPE-ALABI, OLATOKUNBOH SHUKURAT (PHARMD)
Entity type:Individual
Prefix:
First Name:OLATOKUNBOH
Middle Name:SHUKURAT
Last Name:OGUNDIPE-ALABI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1679 BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-2601
Mailing Address - Country:US
Mailing Address - Phone:718-282-7476
Mailing Address - Fax:718-282-0738
Practice Address - Street 1:1679 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-2601
Practice Address - Country:US
Practice Address - Phone:718-282-7476
Practice Address - Fax:718-282-0738
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-15
Last Update Date:2007-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20051058183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist