Individual
MORONKEJI OLAPADE FAGBEMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3 ALBERT CT, VALLEY STREAM, NY 11580-4944
(516) 285-5683
(516) 285-1226
Mailing address
3 ALBERT CT, VALLEY STREAM, NY 11580-4944
(516) 285-5683
(516) 285-1226
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
207287
NY
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
207287
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02073027
—
NY
01
—
207287
LICENSE
NY
Enumeration date
11/28/2006
Last updated
09/11/2025
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