Individual
DR. FOLASHADE O AJEGBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
990 STEWART AVE, SUITE 400, GARDEN CITY, NY 11530-4822
(516) 222-2022
Mailing address
990 STEWART AVE, SUITE 400, GARDEN CITY, NY 11530-4822
(516) 222-2022
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
274344-1
NY
2085R0202X
Diagnostic Radiology Physician
48693
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3101093
—
OH
01
—
P00891133
RAILROAD MEDICARE
OH
Enumeration date
08/21/2007
Last updated
03/08/2017
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