Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 220028 | NY |
N | 2080P0210X | Pediatric Nephrologist | 23259 | OK |
NPI | 1851369334 |
---|---|
Provider Name | Dr. Oluwatoyin F Bamgbola |
First Address | Brooklyn, NY 11236-5720 |
Second Address | New Orleans, LA 70118-5720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 12/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
06572063 | (05) | MS |
1025704 | (05) | LA |