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Individual

DR. OLUSEGUN M ADEONIGBAGBE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
19203 JAMAICA AVE, HOLLIS, NY 11423-2529
(718) 217-7744
(718) 217-7233
Mailing address
1 NORFOLK DRIVE E, ELMONT, NY 11003
(718) 217-7744
(718) 217-7233

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
201260
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000333540101
HEALTHPLUS
05
01624886
NY
01
03590
GHI MEDICARE
NY
01
111948722AD03
CAREPLUS
01
201260
HIP
01
201260-A16
HEALTH FIRST
01
2506098
GHI
NY
01
2588825
AETNA
01
3C2885
HEALTHNET
01
3V1542
BLUE CROSS BLUE SHIELD
01
P00010034
RAILROAD MEDICARE
01
P1300262
OXFORD
01
QN0067201
AMERICHOICE
Enumeration date
04/26/2006
Last updated
08/04/2008
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