MEDICARE: DR. AUGUSTINE T AKALONU MD

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	208000000X	Pediatrics Physician	210150	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	210150	OTHER	NY	LIC. #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275699878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUGUSTINE T AKALONU MD

Provider Business Mailing Address
First Line	:	653 E 233RD ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2801
Country	:	US
Telephone Number	:	718-882-6388
Fax Number	:	718-882-6396

Provider Business Practice Location Address
First Line	:	653 E 233RD ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2801
Country	:	US
Telephone Number	:	718-882-6388
Fax Number	:	718-882-6396

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

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	10/16/2020

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