Provider Demographics
NPI:1225272123
Name:AJAYI, OLATOKUNBO
Entity Type:Individual
Prefix:
First Name:OLATOKUNBO
Middle Name:
Last Name:AJAYI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3348 BARKER AVE
Mailing Address - Street 2:2F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-6360
Mailing Address - Country:US
Mailing Address - Phone:646-338-7940
Mailing Address - Fax:
Practice Address - Street 1:3348 BARKER AVE
Practice Address - Street 2:2F
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-6360
Practice Address - Country:US
Practice Address - Phone:646-338-7940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287064164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse