Provider Demographics
NPI:1326124256
Name:APOESO, TAIYE OLUBUNMI (MD)
Entity Type:Individual
Prefix:DR
First Name:TAIYE
Middle Name:OLUBUNMI
Last Name:APOESO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1225
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-9225
Mailing Address - Country:US
Mailing Address - Phone:718-665-3387
Mailing Address - Fax:718-665-3388
Practice Address - Street 1:3108 THIRD AVENUE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5524
Practice Address - Country:US
Practice Address - Phone:718-665-3387
Practice Address - Fax:718-665-3388
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220927208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02149599Medicaid