Healthcare Provider Details

I. General information

NPI: 1063346021
Provider Name (Legal Business Name): TITILAYO IFEOLUWA DARE-OLIPEDE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 CLARKSON AVE B BUILDING 7TH FLOOR ROOM B7227
BROOKLYN NY
11203-2097
US

IV. Provider business mailing address

451 CLARKSON AVE B BUILDING 7TH FLOOR ROOM B7227
BROOKLYN NY
11203-2097
US

V. Phone/Fax

Practice location:
  • Phone: 718-245-5578
  • Fax:
Mailing address:
  • Phone: 718-245-5578
  • Fax: 646-640-4356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: