Healthcare Provider Details

I. General information

NPI: 1881195881
Provider Name (Legal Business Name): FISAYO TUNDE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLUWAFISAYO TUNDE-AGBEDE MD

II. Dates (important events)

Enumeration Date: 02/24/2018
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3322 US HIGHWAY 22 STE 1302
BRANCHBURG NJ
08876
US

IV. Provider business mailing address

3322 US HIGHWAY 22 STE 1302
BRANCHBURG NJ
08876-4409
US

V. Phone/Fax

Practice location:
  • Phone: 908-526-0700
  • Fax:
Mailing address:
  • Phone: 908-526-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101286620
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA10256700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: