Provider Demographics
NPI:1023981628
Name:OLOJEDE, OLUBUNMI ABIGAIL
Entity type:Individual
Prefix:
First Name:OLUBUNMI
Middle Name:ABIGAIL
Last Name:OLOJEDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3438 BELL BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-1739
Mailing Address - Country:US
Mailing Address - Phone:718-709-0940
Mailing Address - Fax:
Practice Address - Street 1:300 GRANT AVE
Practice Address - Street 2:
Practice Address - City:LAKE KATRINE
Practice Address - State:NY
Practice Address - Zip Code:12449-5340
Practice Address - Country:US
Practice Address - Phone:845-336-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP138616207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine