Organization Active NPI

Irebo Foot and Ankle Surgery

  • Podiatric Clinic/Center
  • Bronx, NY
National Provider Identifier
1720318652
Registry record updated Aug 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
License
006322 Issued in NY
Legal business name
IREBO FOOT AND ANKLE SURGERY
Practice address
444 Willis Ave
Bronx, NY 10455-4013
Phone
(646) 633-1045
NPI assigned
Dec 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Olutunde Aina Shoniregun, DPM
Title
Ceo/Director
Phone
(646) 633-1045

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X 006322 NY Primary

Addresses

Primary practice location

444 Willis Ave
Bronx, NY 10455-4013

Mailing address

1316 E 83Rd St
Brooklyn, NY 11236-5102
Phone (646) 633-1045

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1261612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345075200000",
    "number": "1720318652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 E 83RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112365102",
            "telephone_number": "646-633-1045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 WILLIS AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104554013",
            "telephone_number": "646-633-1045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IREBO FOOT AND ANKLE SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-24",
        "last_updated": "2012-08-16",
        "status": "A",
        "authorized_official_last_name": "SHONIREGUN",
        "authorized_official_first_name": "OLUTUNDE",
        "authorized_official_middle_name": "AINA",
        "authorized_official_title_or_position": "CEO/DIRECTOR",
        "authorized_official_telephone_number": "646-633-1045",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NY",
            "license": "006322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.