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NPI Code Detail

MEDICARE: DR. OLULEKE ZACCHEUS M.D.

MEDICARE: DR. OLULEKE ZACCHEUS M.D.
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
1207R00000XInternal Medicine PhysicianP131670NY

General Provider Information

NPI Number : 1477815082
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. OLULEKE ZACCHEUS M.D.
Provider Business Mailing Address
First Line : 242 E 110TH ST APT 1
Second Line :
City : NEW YORK
State : NY
Zip : 10029-3364
Country : US
Telephone Number : 201-218-8564
Fax Number :
Provider Business Practice Location Address
First Line : 6970 GRAND CENTRAL PKWY
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-3949
Country : US
Telephone Number : 718-263-4600
Fax Number : 718-263-4910
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2012
Last Update Date : 12/20/2024

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