Adeonigbagbe, Olusegun M

Adeonigbagbe, Olusegun M is an sole proprietor health care provider with primary practice located at 19203 Jamaica Ave , Hollis NY 11423-2529. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Adeonigbagbe, Olusegun M can be contacted via phone (718) 217-7744.

Contact Information

Primary practice address
19203 Jamaica Ave Hollis NY 11423-2529
Phone: (718) 217-7744
Fax: (718) 217-7233
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 201260 New York

Profile Details

NPI number 1073570081
LBN Legal business name Adeonigbagbe, Olusegun M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 26th, 2006
Last updated Aug 4th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073570081 NPPES
Other 2588825 AETNA
Other P00010034 AETNA
Other QN0067201 AETNA
Other 3V1542 AETNA
MEDICAID 01624886 AETNA
Other 3C2885 AETNA
Other 111948722AD03 AETNA
Other 2506098 AETNA
Other 000333540101 AETNA
Other P1300262 AETNA
Other 03590 AETNA
Other 201260 AETNA
Other 201260-A16 AETNA

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