Provider Demographics
NPI:1245580984
Name:ALONGE, YEWANDE OLATEJU (OD)
Entity Type:Individual
Prefix:DR
First Name:YEWANDE
Middle Name:OLATEJU
Last Name:ALONGE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:YEWANDE
Other - Middle Name:OLATEJU
Other - Last Name:OLAGOKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:6212 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-0049
Mailing Address - Country:US
Mailing Address - Phone:919-781-4266
Mailing Address - Fax:
Practice Address - Street 1:6212 GLENWOOD AVE STE 101
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-2657
Practice Address - Country:US
Practice Address - Phone:919-781-4266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2296152WC0802X, 152WL0500X, 152WP0200X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics