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Individual

DR. JOHN BABALOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
260 W SUNRISE HWY, STE 200, VALLEY STREAM, NY 11581-1011
(516) 825-3600
Mailing address
55 WATER ST, 12TH FLOOR, CREDENTIALING, NEW YORK, NY 10041-0004
(646) 680-2888
(516) 542-5556

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
229550
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02983571
NY
Enumeration date
03/17/2006
Last updated
02/02/2017
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