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General NPI Number Information
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NPI Number | 1407719339
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Entity Type | Organization
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Legal Business Name | CITYBLOCK IPA NY, LLC
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 1259 BEDFORD AVE
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City | BROOKLYN
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State | NY
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Zip | 11216-1813
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Country | US
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Telephone | 833-904-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 495 FLATBUSH AVE
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City | BROOKLYN
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State | NY
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Zip | 11225-3706
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO, CITYBLOCK HEALTH, INC.
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Name | OLUWATOYIN AJAYI
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Credential | MD
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Telephone | 347-463-5529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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