Individual
FATAI ADESINA GBADAMOSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
206 S ELMWOOD AVE, BUFFALO, NY 14201-2398
(716) 847-0328
(716) 847-2715
Mailing address
206 S ELMWOOD AVE, BUFFALO, NY 14201-2398
(716) 847-0328
(716) 847-2715
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
248561
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00025064402
UNIVERA
NY
01
—
000525978004
BLUE CROSS & BLUE SHIELD
NY
05
—
02050035
—
NY
01
—
0410964
INDEPENDENT HEALTH
NY
Enumeration date
05/09/2006
Last updated
12/09/2011
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