Provider Demographics
NPI:1639129612
Name:ARIYIBI, OLUYEMISI OMOTOLA (MD)
Entity Type:Individual
Prefix:
First Name:OLUYEMISI
Middle Name:OMOTOLA
Last Name:ARIYIBI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OLUYEMISI
Other - Middle Name:OMOTOLA
Other - Last Name:SENBORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:389 E 89TH ST
Mailing Address - Street 2:APT 9C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5067
Mailing Address - Country:US
Mailing Address - Phone:917-757-0742
Mailing Address - Fax:
Practice Address - Street 1:1901 1ST AVE
Practice Address - Street 2:METROPOLITAN HOSPITAL CENTER, DEPT OF MEDICINE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-7404
Practice Address - Country:US
Practice Address - Phone:212-423-6771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234131207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine