Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Samuel Obisanya

Individual provider Licensed Vocational Nurse · NPI 1063866002

Samuel Obisanya is a Licensed Vocational Nurse in Staten Island, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2016
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Practice location Address checks out

69 Birch Rd Apt 1
Staten Island, NY 10303-1718
Phone: (347) 994-6911
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Vocational Nurse (primary) Taxonomy 164X00000X · Licence 310996 (NY)

Record details

NPI number1063866002
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 15, 2016
Last updated in NPPESApril 15, 2016
Mailing address69 Birch Rd Apt 1, Staten Island, NY 10303-1718

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