Provider Demographics
NPI:1073790721
Name:AYENI-SWANSTON, OLUWATOYIN EUNICE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:OLUWATOYIN
Middle Name:EUNICE
Last Name:AYENI-SWANSTON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11423 199TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-2822
Mailing Address - Country:US
Mailing Address - Phone:917-348-3646
Mailing Address - Fax:
Practice Address - Street 1:1467 FIRST AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075
Practice Address - Country:US
Practice Address - Phone:212-585-2108
Practice Address - Fax:212-585-2113
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042257-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist