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General NPI Number Information
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NPI Number | 1356603260
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Entity Type | Individual
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Provider Name | MORENIKEJI AYODELE BURAIMOH M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2012
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 130 BIRDSEYE RD
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City | FARMINGTON
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State | CT
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Zip | 06032-2444
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Country | US
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Telephone | 860-247-3279
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Fax |
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Provider Business Mailing Address
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Address Line | 195 STEELE RD
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City | WEST HARTFORD
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State | CT
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Zip | 06119-1050
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Country | US
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Telephone | 617-281-4340
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | D85694
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | D85694
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 69859
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 69859
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License Number State | CT
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