Provider Demographics
NPI:1528610383
Name:IGBINOSUN, BRIDGET ABIEYUWA (MD)
Entity type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:ABIEYUWA
Last Name:IGBINOSUN
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 ATWELL RD
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-1301
Mailing Address - Country:US
Mailing Address - Phone:607-433-1790
Mailing Address - Fax:607-433-6608
Practice Address - Street 1:125 MAIN ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2507
Practice Address - Country:US
Practice Address - Phone:607-433-1790
Practice Address - Fax:607-433-6608
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY317924208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics