Individual
DR. GBOLAGADE O BABALOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
147 LAKE ST, NEWBURGH, NY 12550-5263
(845) 563-8000
(845) 565-1364
Mailing address
2570 ROUTE 9W STE 10, CORNWALL, NY 12518-1370
(845) 220-3100
(845) 534-2940
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
25MB08334000
NJ
207V00000X
Obstetrics & Gynecology Physician
Primary
296706
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0174696
—
NJ
05
—
101291335
—
PA
Enumeration date
07/22/2005
Last updated
01/15/2019
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