Daccu Bamidele Sonubiishaq, is a
Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities based in East Orange, New Jersey. Daccu Bamidele Sonubiishaq is licensed to practice in * (Not Available) (license number ) and her current practice location is
99 Lenox Ave Fl 1, East Orange, New Jersey. She can be reached at her office (for appointments etc.) via phone at
(309) 966-5184.
NPI number for Daccu Bamidele Sonubiishaq is 1255055356 and her current mailing address is 99 Lenox Ave Fl 1, East Orange, New Jersey. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1255055356.
Provider's Profile
Full Name | Daccu Bamidele Sonubiishaq |
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Gender | Female |
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Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
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Location | 99 Lenox Ave Fl 1, East Orange, New Jersey |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1255055356
- Provider Enumeration Date: 10/03/2022
- Last Update Date: 11/22/2024
Medical Identifiers
Medical identifiers for Daccu Bamidele Sonubiishaq such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1255055356 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 953594-01 (New York) | Secondary |
164W00000X | Licensed Practical Nurse | 97121 (Tennessee) | Secondary |
320900000X | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Daccu Bamidele Sonubiishaq is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Daccu Bamidele Sonubiishaq, 99 Lenox Ave Fl 1, East Orange, NJ 07018-3102 Ph: (309) 966-5184 | Daccu Bamidele Sonubiishaq, 99 Lenox Ave Fl 1, East Orange, NJ 07018-3102 Ph: (309) 966-5184 |
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