Healthcare Provider Details

I. General information

NPI: 1285817551
Provider Name (Legal Business Name): ADERONKE AYODELE OGUNTOYE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 5TH AVE
NEW YORK NY
10016-5010
US

IV. Provider business mailing address

347 5TH AVE
NEW YORK NY
10016-5010
US

V. Phone/Fax

Practice location:
  • Phone: 646-461-3611
  • Fax:
Mailing address:
  • Phone: 646-461-3611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD039818
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number266011
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number239796
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: