Provider Demographics
NPI:1912042169
Name:OSEI TUTU, JOHN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:OSEI TUTU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1154 WHEELER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-3306
Mailing Address - Country:US
Mailing Address - Phone:718-991-9200
Mailing Address - Fax:718-991-2606
Practice Address - Street 1:1154 WHEELER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-3306
Practice Address - Country:US
Practice Address - Phone:718-991-9200
Practice Address - Fax:718-991-2606
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1567592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY30D061Medicare PIN