Individual
DR. TAIYE O ODEDOSU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
462 1ST AVENUE, 27TH STREET, BELLEVUE HOSPITAL, MODULE C,, NEW YORK, NY 10016
(212) 562-1619
Mailing address
225 E 95TH ST APT 20K, NEW YORK, NY 10128-4007
(917) 952-9562
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
238193
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
251296
MDID
NY
Enumeration date
11/17/2006
Last updated
07/08/2007
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