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NPI Code Detail

MEDICARE: OLUWATOSIN GBADAMOSI

MEDICARE: OLUWATOSIN GBADAMOSI
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
1251B00000XCase Management Agency

General Provider Information

NPI Number : 1780238493
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLUWATOSIN GBADAMOSI
Provider Business Mailing Address
First Line : 9114 MERRICK BLVD
Second Line :
City : JAMAICA
State : NY
Zip : 11432-5363
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9114 MERRICK BLVD
Second Line :
City : JAMAICA
State : NY
Zip : 11432-5363
Country : US
Telephone Number : 718-408-7178
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2019
Last Update Date : 07/31/2019

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Directions to “ OLUWATOSIN GBADAMOSI ” Practice Location

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