Provider Demographics
NPI:1508527946
Name:AJIKAN, OLORUNFEMI EMMANUEL (MBBS)
Entity Type:Individual
Prefix:DR
First Name:OLORUNFEMI
Middle Name:EMMANUEL
Last Name:AJIKAN
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:NOT APPLICABLE
Other - Middle Name:NOT APPLICABLE
Other - Last Name:NOT APPLICABLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MBBS
Mailing Address - Street 1:1371 SEABURY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-3651
Mailing Address - Country:US
Mailing Address - Phone:201-419-3335
Mailing Address - Fax:
Practice Address - Street 1:2700 EASTCHESTER RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5923
Practice Address - Country:US
Practice Address - Phone:201-419-3335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP113301208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice