Healthcare Provider Details

I. General information

NPI: 1922029651
Provider Name (Legal Business Name): RAFIU OLAGBOYEGA ARIGANJOYE MD,MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 SELWYN AVE DEPARTMENT OF PEDIATRICS, SUITE 6-D
BRONX NY
10457-7626
US

IV. Provider business mailing address

13 NORBRIDGE DR
PRINCETON NJ
08540-6119
US

V. Phone/Fax

Practice location:
  • Phone: 718-518-5760
  • Fax: 718-518-5124
Mailing address:
  • Phone: 917-405-5260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA06954400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: