Individual
DR. OLATUNDE OSOFISAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1545 ATLANTIC AVE, BROOKLYN, NY 11213-1122
(718) 613-7005
Mailing address
295 THROOP AVE, APT 1B, BROOKLYN, NY 11206-7121
(917) 826-7794
(718) 613-6527
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
R76156
NY
213EP1101X
Primary Podiatric Medicine Podiatrist
R76156
NY
213ES0000X
Sports Medicine Podiatrist
R76156
NY
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
R76156
NY
Other
Enumeration date
09/26/2011
Last updated
09/26/2011
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