Organization Active NPI

Tunde Osofisan, DPM P.C.

  • Podiatric Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1962826768
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
License
N006467 Issued in NY
Legal business name
TUNDE OSOFISAN, DPM P.C.
Practice address
295 Throop Ave
1B
Brooklyn, NY 11206-7121
Phone
(917) 826-7794
Fax
(718) 613-4898
NPI assigned
Feb 13, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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

Authorized official

Name
Tunde Osofisan, DPM
Title
Owner
Phone
(917) 826-7794

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X N006467 NY Primary

Addresses

Primary practice location

295 Throop Ave
1B
Brooklyn, NY 11206-7121

Mailing address

295 Throop Ave
1B
Brooklyn, NY 11206-7121
Phone (917) 826-7794

Other identifiers 1

IdentifierTypeStateIssuer
03618760MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1392249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392249600000",
    "number": "1962826768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 THROOP AVE",
            "address_2": "1B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112067121",
            "telephone_number": "917-826-7794",
            "fax_number": "718-613-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 THROOP AVE",
            "address_2": "1B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112067121",
            "telephone_number": "917-826-7794",
            "fax_number": "718-613-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUNDE OSOFISAN, DPM P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-13",
        "last_updated": "2014-02-13",
        "status": "A",
        "authorized_official_last_name": "OSOFISAN",
        "authorized_official_first_name": "TUNDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-826-7794",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NY",
            "license": "N006467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03618760",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; 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.