Healthcare Provider Details

I. General information

NPI: 1245332345
Provider Name (Legal Business Name): SUZETTE OLUBUSOLA OYEKU MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 10/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3444 KOSSUTH AVE CHILDREN'S HOSPITAL AT MONTEFIORE/FAMILY CARE CENTER
BRONX NY
10467-2410
US

IV. Provider business mailing address

4901 HENRY HUDSON PKWY W APT 8G
BRONX NY
10471-3217
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-6050
  • Fax:
Mailing address:
  • Phone: 718-796-3403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number240819
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: