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NPI Code Detail

MEDICARE: BABATUNJI O OMOTOSO MD

MEDICARE: BABATUNJI O OMOTOSO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician191033NY
2207L00000XAnesthesiology PhysicianMA 65839NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336146851
Entity Type Code : Individual
Provider Name (Legal Business Name) : BABATUNJI O OMOTOSO MD
Provider Business Mailing Address
First Line : 575 LEXINGTON AVE RM 2100
Second Line :
City : NEW YORK
State : NY
Zip : 10022-6108
Country : US
Telephone Number : 646-962-9930
Fax Number :
Provider Business Practice Location Address
First Line : 5645 MAIN ST
Second Line :
City : FLUSHING
State : NY
Zip : 11355-5045
Country : US
Telephone Number : 718-670-2597
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 10/08/2024

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Directions to “ BABATUNJI O OMOTOSO MD” Practice Location

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