Ogunfowora, Olusegun
Ogunfowora, Olusegun is an sole proprietor health care provider with primary practice located at 529 Beach 20Th St , Far Rockaway NY 11691-3645. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Ogunfowora, Olusegun can be contacted via phone (718) 327-7307.Contact Information
Primary practice address
529 Beach 20Th St
Far Rockaway NY 11691-3645
Phone: (718) 327-7307
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 206115-1 | New York |
Profile Details
| NPI number | 1275602963 |
|---|---|
| LBN Legal business name | Ogunfowora, Olusegun |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 7th, 2006 |
| Last updated | Aug 12th, 2016 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275602963 | NPPES |
| New York | MEDICAID | 01775084 |
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