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Individual

DR. OLADIPO O ITABIYI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D

Contact information

Practice address
1234 HARSHAW RD, BROOKHAVEN, PA 19015-1908
(610) 876-1744
(610) 876-1744
Mailing address
PO BOX 1641, BROOKHAVEN, PA 19015-0641
(610) 505-9618

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG002206
PA

Other

Enumeration date
10/20/2009
Last updated
10/20/2009
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