Provider Demographics
NPI:1437968039
Name:NUEBAC LLC
Entity type:Organization
Organization Name:NUEBAC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPEDIC SPINE SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:GBOLABO
Authorized Official - Middle Name:
Authorized Official - Last Name:SOKUNBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-690-8500
Mailing Address - Street 1:523 E 72ND ST FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4099
Mailing Address - Country:US
Mailing Address - Phone:646-797-8500
Mailing Address - Fax:917-260-4565
Practice Address - Street 1:523 E 72ND ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4099
Practice Address - Country:US
Practice Address - Phone:646-797-8500
Practice Address - Fax:917-260-4565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty