Healthcare Provider Details

I. General information

NPI: 1235190133
Provider Name (Legal Business Name): TOSAN ORUWARIYE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TOSAN AKPORIAYE MD

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3510 BAINBRIDGE AVE APT S5
BRONX NY
10467-1419
US

IV. Provider business mailing address

PO BOX 672170
BRONX NY
10467-0803
US

V. Phone/Fax

Practice location:
  • Phone: 718-881-8999
  • Fax: 718-881-1984
Mailing address:
  • Phone: 718-881-8999
  • Fax: 718-881-1984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number209367
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: