Kayode Odutayo Md Pllc | |
1000 Pelham Pkwy S Bronx NY 10461-1003 | |
(631) 209-5369 | |
Not Available |
Full Name | Kayode Odutayo Md Pllc |
---|---|
Speciality | Internal Medicine |
Location | 1000 Pelham Pkwy S, Bronx, New York |
Authorized Official Name and Position | Kayode Odutayo (MD/OWNER) |
Authorized Official Contact | 6312095369 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Kayode Odutayo Md Pllc 150 Motor Pkwy Ste 4012324 Hauppauge NY 11788-5145 Ph: (631) 209-5369 | Kayode Odutayo Md Pllc 1000 Pelham Pkwy S Bronx NY 10461-1003 Ph: (631) 209-5369 |
NPI Number | 1427805746 |
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Provider Enumeration Date | 05/03/2024 |
Last Update Date | 05/03/2024 |
Medicare PECOS PAC ID | 6204278658 |
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Medicare Enrollment ID | O20240530001841 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427805746 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Kayode Odutayo |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1790118875 PECOS PAC ID: 2567756992 Enrollment ID: I20181114000931 |
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