Individual
DR. OLUYOMI EDITH AJISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-5696
Mailing address
3450 WAYNE AVE, APARTMENT 16J, BRONX, NY 10467-2510
(646) 709-2250
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
01070299A
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
P69842
NY
Other
Enumeration date
04/28/2008
Last updated
07/11/2012
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