MEDICARE: JOHN OSEI TUTU 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
1	2084P0800X	Psychiatry Physician	156759	NY

General Provider Information

NPI Number	:	1912042169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN OSEI TUTU MD

Provider Business Mailing Address
First Line	:	1154 WHEELER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-3306
Country	:	US
Telephone Number	:	718-991-9200
Fax Number	:	718-991-2606

Provider Business Practice Location Address
First Line	:	1154 WHEELER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-3306
Country	:	US
Telephone Number	:	718-991-9200
Fax Number	:	718-991-2606

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	12/12/2007

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