Individual ProviderAisabomen Musa-AgboneniSocial WorkerBehavioral Health & Social Service ProvidersPractice Address260 Broadway, Brooklyn, NY 11211-8433(540) 849-5152(347) 788-8216PECOS EnrollmentBased on the most recent information from CMS, provider Aisabomen Musa-Agboneni is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1346717915Provider TypeIndividualFull NameMusa-Agboneni, AisabomenCredentialLCSWGenderMaleSole ProprietorNoEnumeration Date10/31/2018Last Updated11/29/2025Contact InformationPractice LocationPractice Address260 Broadway, Brooklyn, NY 11211-8433Phone(540) 849-5152FaxUnlisted FaxMailing LocationMailing Address350 Vanderbilt Ave, Staten Island, NY 10304-3570Phone(347) 788-8216FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense101524-01New YorkCode104100000XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense100867-1New York