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

Oluwaseun Ambode

Individual provider Physical Therapist · NPI 1437662293

Oluwaseun Ambode is a Physical Therapist in Private Practice in Great Neck, New York. Qualified in 2017, 9 years ago. Licensed in New York.

Years since qualifying
9
Licensed in
NY
In the registry since
2017
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Practice location Address checks out

475 Northern Blvd Ste 11
Great Neck, NY 11021-4802
Phone: (516) 829-0030
Fax: (516) 466-7723
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 042239 (NY)

Record details

NPI number1437662293
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 14, 2017
Last updated in NPPESNovember 14, 2017
Mailing address475 Northern Blvd Ste 11, Great Neck, NY 11021-4802

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Great Neck