Organization
FOUNTAIN PULMONARY P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADEBAMBO DOLAPO OLAJITAN M.D., FCCP (PRESIDENT)
(347) 562-2753
Entity
Organization
Contact information
Practice address
800 MANOR RD, SUITE 3, STATEN ISLAND, NY 10314-7034
(347) 562-2753
(347) 289-5100
Mailing address
800 MANOR RD, SUITE 3, STATEN ISLAND, NY 10314-7034
(347) 562-2753
(347) 289-5100
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
212276
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01883816
—
NY
Enumeration date
08/09/2006
Last updated
07/16/2010
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