Provider Demographics
NPI:1477572758
Name:AKINLAWON, AKINTAYO OLUWATOSIN (MD,MPH)
Entity Type:Individual
Prefix:DR
First Name:AKINTAYO
Middle Name:OLUWATOSIN
Last Name:AKINLAWON
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 JAY ALLEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:PAINTED POST
Mailing Address - State:NY
Mailing Address - Zip Code:14870
Mailing Address - Country:US
Mailing Address - Phone:607-936-4042
Mailing Address - Fax:607-936-4042
Practice Address - Street 1:76 VETERANS AVENUE
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:NY
Practice Address - Zip Code:14810
Practice Address - Country:US
Practice Address - Phone:607-664-4306
Practice Address - Fax:607-664-4320
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01053638A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AV4731217AA6OtherVETERAN AFFAIRS NUMBER