Provider Demographics
NPI:1831620384
Name:AKAGBOSU, CYNTHIA OMOGE (MD, MA)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:OMOGE
Last Name:AKAGBOSU
Suffix:
Gender:F
Credentials:MD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 W 168TH ST FL 17
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:212-305-5903
Mailing Address - Fax:
Practice Address - Street 1:622 W 168TH ST FL 17
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-5903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY323185208000000X, 207RG0100X, 2080B0002X, 2080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No2080B0002XAllopathic & Osteopathic PhysiciansPediatricsObesity Medicine