Healthcare Provider Details

I. General information

NPI: 1447245097
Provider Name (Legal Business Name): T. KEMI BABAGBEMI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TOKUNBO OLUKEMI BABAGBEMI M.D.

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST RADIOLOGY,CORNELL/NEW YORK PRESBYTERIAN
NEW YORK NY
10021-4870
US

IV. Provider business mailing address

425 E 61ST ST FL 9
NEW YORK NY
10065-8790
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-2520
  • Fax: 212-746-8596
Mailing address:
  • Phone: 212-821-0680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number213848
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number213848
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number241593
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: