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Organization

DOSU MEDICAL PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS OMOTOLA TEYIBO M.D (PRESIDENT)
(347) 265-1986
Entity
Organization

Contact information

Practice address
1150 WEBSTER AVE, SUITE 2, BRONX, NY 10456-5205
(347) 271-7666
Mailing address
1135 ALLERTON AVE, BRONX, NY 10469-5316
(347) 427-2953

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1871686097
NPI
NY
Enumeration date
05/17/2016
Last updated
01/12/2017
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