Olusola O Sanusi-agbabiaka, MD is a medicare enrolled "Emergency Medicine" in Brooklyn, New York. His current practice location is
451 Clarkson Ave, Brooklyn, New York. You can reach out to his office (for appointments etc.) via phone at
(718) 245-3131.
Olusola O Sanusi-agbabiaka is licensed to practice in New York (license number 302725) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1417106477.
Provider's Profile
| Full Name | Olusola O Sanusi-agbabiaka |
|---|
| Gender | Male |
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| Speciality | Emergency Medicine |
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| Location | 451 Clarkson Ave, Brooklyn, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1417106477
- Provider Enumeration Date: 09/15/2008
- Last Update Date: 11/24/2020
Medicare PECOS Information:
- PECOS PAC ID: 1850512955
- Enrollment ID: I20141014001293
Medical Identifiers
Medical identifiers for Olusola O Sanusi-agbabiaka such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1417106477 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | (New York) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 207P00000X | Emergency Medicine | 302725 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Olusola O Sanusi-agbabiaka is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Olusola O Sanusi-agbabiaka, MD
451 Clarkson Ave,
Brooklyn, NY 11203-2054
Ph: (718) 245-3131 | Olusola O Sanusi-agbabiaka, MD
451 Clarkson Ave,
Brooklyn, NY 11203-2054
Ph: (718) 245-3131 |
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