Olakunle Kayode Oluwole, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

25MA07993500 Issued in NJ

Practice address

379 Old Tappan Rd
Old Tappan, NJ 07675-6806

Phone

(631) 581-4400

Fax

(631) 277-3750

NPI assigned

Mar 14, 2006

Last updated

Nov 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1932177144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 OLD TAPPAN RD",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076756806",
            "telephone_number": "201-681-9700",
            "fax_number": "201-681-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 OLD TAPPAN RD",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076756806",
            "telephone_number": "631-581-4400",
            "fax_number": "631-277-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLUWOLE",
        "first_name": "OLAKUNLE",
        "middle_name": "KAYODE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA07993500",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD428526",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "047735",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "212153",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olubunmi E Okunlola, MD
• Old Tappan Chiropractic, PA
• Old Tappan Medical Group Dept of Internal Medicine, LLC
• Old Tappan Medical Group, PA
• Old Tappan Pediatrics
• Ozzy Sanchez, LCSW (theSTARTinstitute)
• Helen Papadatos
• Diane M Park, LCSW
• Jooyoung Park, PHARM.D.
• Ju Young Park

• Surgery Physician in Old Tappan, NJ
• Providers in Old Tappan, NJ by specialty
• Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.