Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 250591 | NY |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 25MA09331900 | NJ |
NPI | 1689996142 |
---|---|
Provider Name | Dr. Osamuede Folorunsho Edobor-Osula |
First Address | Newark, NJ 07103-2425 |
Second Address | Newark, NJ 07103-2425 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2010 |
Last Update Date | 15/01/2014 |