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NPI Code Detail

MEDICARE: YETUNDE OGUNTADE NP

MEDICARE: YETUNDE OGUNTADE NP
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
1363LF0000XFamily Nurse Practitioner346538NY
2163W00000XRegistered Nurse665819NY

General Provider Information

NPI Number : 1962740191
Entity Type Code : Individual
Provider Name (Legal Business Name) : YETUNDE OGUNTADE NP
Provider Business Mailing Address
First Line : 815 BROADWAY
Second Line :
City : BROOKLYN
State : NY
Zip : 11206-5318
Country : US
Telephone Number : 844-692-4692
Fax Number : 646-614-8385
Provider Business Practice Location Address
First Line : 815 BROADWAY
Second Line :
City : BROOKLYN
State : NY
Zip : 11206-5318
Country : US
Telephone Number : 646-614-8329
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2013
Last Update Date : 09/23/2025

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Directions to “ YETUNDE OGUNTADE NP” Practice Location

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