Provider Demographics
NPI:1790826733
Name:OGEDEGBE, ANTHONY ONEORITSEBAWOETE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:ONEORITSEBAWOETE
Last Name:OGEDEGBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:350 E 82ND ST APT 4N
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-4912
Mailing Address - Country:US
Mailing Address - Phone:646-369-4026
Mailing Address - Fax:212-746-4734
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4870
Practice Address - Country:US
Practice Address - Phone:212-746-4071
Practice Address - Fax:212-746-4734
Is Sole Proprietor?:No
Enumeration Date:2007-02-11
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY240713207R00000X, 207RI0200X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY240713OtherNEW YORK STATE MEDICAL LICENSE