Provider Demographics
NPI:1306418355
Name:AYANGBAYI, FEHINTOLA O (RN)
Entity Type:Individual
Prefix:
First Name:FEHINTOLA
Middle Name:O
Last Name:AYANGBAYI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:FEHINTOLA
Other - Middle Name:O
Other - Last Name:MANSARAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:589 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-2527
Mailing Address - Country:US
Mailing Address - Phone:973-494-4629
Mailing Address - Fax:718-347-4643
Practice Address - Street 1:589 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205-2527
Practice Address - Country:US
Practice Address - Phone:973-494-4629
Practice Address - Fax:718-347-4643
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-10
Last Update Date:2021-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY786958163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse