Provider Demographics
NPI:1245922509
Name:AMOO, ATINUKE ANJOOLA (MD)
Entity type:Individual
Prefix:DR
First Name:ATINUKE
Middle Name:ANJOOLA
Last Name:AMOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COLUMBIA ST, SUITE 302
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601
Mailing Address - Country:US
Mailing Address - Phone:845-790-1317
Mailing Address - Fax:
Practice Address - Street 1:45 READE PLACE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3990
Practice Address - Country:US
Practice Address - Phone:845-790-1317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2024-04-10
Deactivation Date:2023-12-26
Deactivation Code:
Reactivation Date:2024-04-10
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program