Provider Demographics
NPI:1063701001
Name:OJARIKRE, AUGUSTINE (LPN)
Entity type:Individual
Prefix:
First Name:AUGUSTINE
Middle Name:
Last Name:OJARIKRE
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 E KINGSBRIDGE RD
Mailing Address - Street 2:APT-4A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-4413
Mailing Address - Country:US
Mailing Address - Phone:718-671-2100
Mailing Address - Fax:
Practice Address - Street 1:229 E KINGSBRIDGE RD
Practice Address - Street 2:APT-4A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-4413
Practice Address - Country:US
Practice Address - Phone:718-671-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304721164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse