Provider Demographics
NPI:1326517459
Name:OWOYELE-ALAKE, OLUWATOYOSI ENIOLA (NP)
Entity Type:Individual
Prefix:
First Name:OLUWATOYOSI
Middle Name:ENIOLA
Last Name:OWOYELE-ALAKE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27005 76TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:287 PARK AVE S FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4573
Practice Address - Country:US
Practice Address - Phone:888-553-2823
Practice Address - Fax:888-553-2823
Is Sole Proprietor?:No
Enumeration Date:2018-11-19
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343862363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily