Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ololade Omitogun

Individual provider Internal Medicine Physician · NPI 1225978703

Ololade Omitogun is an Internal Medicine in Lake Katrine, New York. Qualified in 2013, 13 years ago. Licensed in New York.

Years since qualifying
13
Licensed in
NY
In the registry since
2026

Practice location Address checks out

300 Grant Ave
Lake Katrine, NY 12449-5340
Phone: (718) 709-0940
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence P141024 (NY)

Record details

NPI number1225978703
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 1, 2026
Last updated in NPPESApril 1, 2026
Certification dateApril 1, 2026
Mailing address3438 Bell Blvd, Bayside, NY 11361-1739

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

Other providers in Lake Katrine