Provider Demographics
NPI:1699853515
Name:OKUNLOLA, TITUS BABAWALE (MD)
Entity Type:Individual
Prefix:DR
First Name:TITUS
Middle Name:BABAWALE
Last Name:OKUNLOLA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:406 SUSSEX RD
Mailing Address - Street 2:BABOK MEDICAL HEALTH SERVICES
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-4224
Mailing Address - Country:US
Mailing Address - Phone:718-363-3040
Mailing Address - Fax:718-363-3044
Practice Address - Street 1:1040 WINTHROP STREET
Practice Address - Street 2:BABOK MEDICAL HEALTH SERVICES
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-1452
Practice Address - Country:US
Practice Address - Phone:718-363-3040
Practice Address - Fax:718-363-3044
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2015-06-16
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Provider Licenses
StateLicense IDTaxonomies
NY2330112084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02832231Medicaid
PA1024640750001Medicaid
PA1024640750001Medicaid