Healthcare Provider Details

I. General information

NPI: 1023697091
Provider Name (Legal Business Name): VIVIANNE OYEFUSI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 MADISON ST
NEW YORK NY
10002-7537
US

IV. Provider business mailing address

227 MADISON ST
NEW YORK NY
10002-7537
US

V. Phone/Fax

Practice location:
  • Phone: 212-238-7000
  • Fax: 212-238-7668
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number339623
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: