Provider Demographics
NPI:1881195881
Name:TUNDE, FISAYO (MD)
Entity Type:Individual
Prefix:DR
First Name:FISAYO
Middle Name:
Last Name:TUNDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:OLUWAFISAYO
Other - Middle Name:
Other - Last Name:TUNDE-AGBEDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3322 US HIGHWAY 22 STE 1302
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-4409
Mailing Address - Country:US
Mailing Address - Phone:908-526-0700
Mailing Address - Fax:
Practice Address - Street 1:3322 US HIGHWAY 22 STE 1302
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876
Practice Address - Country:US
Practice Address - Phone:908-526-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-24
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10256700207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology