Individual
LILY O OTOLORIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2337 KEW GARDENS DR, WOODBRIDGE, VA 22191-6577
(646) 593-6787
Mailing address
PO BOX 4212, WOODBRIDGE, VA 22194-4212
(646) 593-6787
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
53928
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53928
WI STATE LIC
WI
Enumeration date
03/29/2010
Last updated
12/06/2016
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