Provider Demographics
NPI:1235429689
Name:BAMITEKO, DAYO T (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAYO
Middle Name:T
Last Name:BAMITEKO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 NORFOLK DR W
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4814
Mailing Address - Country:US
Mailing Address - Phone:347-661-0534
Mailing Address - Fax:718-484-2171
Practice Address - Street 1:596 CLARKSON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2115
Practice Address - Country:US
Practice Address - Phone:718-484-7213
Practice Address - Fax:718-484-2171
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038542183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist