Provider Demographics
NPI:1578256277
Name:OGUNYEMI, ELIZABETH OLAYINKA (RN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:OLAYINKA
Last Name:OGUNYEMI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 E 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-4815
Mailing Address - Country:US
Mailing Address - Phone:347-744-2324
Mailing Address - Fax:
Practice Address - Street 1:1117 E 15TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-4815
Practice Address - Country:US
Practice Address - Phone:347-744-2324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY880309163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse