Provider Demographics
NPI:1528215035
Name:AKINOLA, OLAJIDE
Entity Type:Individual
Prefix:
First Name:OLAJIDE
Middle Name:
Last Name:AKINOLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-6610
Mailing Address - Country:US
Mailing Address - Phone:516-385-5297
Mailing Address - Fax:
Practice Address - Street 1:18 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-6610
Practice Address - Country:US
Practice Address - Phone:516-385-5297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263289164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse