Organization
KUPONIYI FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOJISOLA DABNEY (CEO)
(609) 534-5859
Entity
Organization
Contact information
Practice address
199 NEW RD, SUITE 61-398, LINWOOD, NJ 08221-2025
(609) 534-5859
Mailing address
199 NEW RD, SUITE 61-398, LINWOOD, NJ 08221-2025
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
02/23/2016
Last updated
02/23/2016
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