| Olukitibi Care Medical Practice, Pc | |
|
79 Route 59 Ste 2 Suffern NY 10901-4900 | |
| (404) 287-4401 | |
| Not Available |
| Full Name | Olukitibi Care Medical Practice, Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 79 Route 59 Ste 2, Suffern, New York |
| Authorized Official Name and Position | Olanrewaju Olukitibi (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4042874401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Olukitibi Care Medical Practice, Pc 79 Route 59 Ste 2 Suffern NY 10901-4900 Ph: (404) 287-4401 | Olukitibi Care Medical Practice, Pc 79 Route 59 Ste 2 Suffern NY 10901-4900 Ph: (404) 287-4401 |
| NPI Number | 1821774738 |
|---|---|
| Provider Enumeration Date | 06/26/2023 |
| Last Update Date | 06/26/2023 |
| Certification Date | 06/26/2023 |
| Medicare PECOS PAC ID | 6406217595 |
|---|---|
| Medicare Enrollment ID | O20230807000070 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821774738 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Olanrewaju E Olukitibi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710384326 PECOS PAC ID: 8426312810 Enrollment ID: I20180511001195 |
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