Organization
IREBO FOOT AND ANKLE SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLUTUNDE AINA SHONIREGUN DPM (CEO/DIRECTOR)
(646) 633-1045
Entity
Organization
Contact information
Practice address
444 WILLIS AVE, BRONX, NY 10455-4013
(646) 633-1045
Mailing address
1316 E 83RD ST, BROOKLYN, NY 11236-5102
(646) 633-1045
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
006322
NY
Other
Enumeration date
12/24/2009
Last updated
08/16/2012
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