MEDICARE: OLUWAFEYIKEMI OKOME

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207WX0009X	Glaucoma Specialist (Ophthalmology) Physician	111077	GA

General Provider Information

NPI Number	:	1245989748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLUWAFEYIKEMI OKOME

Provider Business Mailing Address
First Line	:	111 E 210TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2401
Country	:	US
Telephone Number	:	718-920-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 E 210TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2401
Country	:	US
Telephone Number	:	718-920-2020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2022
Last Update Date	:	03/18/2026

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