Provider Demographics
NPI:1639592512
Name:A & T FAMILY MEDICAL, LLC
Entity Type:Organization
Organization Name:A & T FAMILY MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNP-FNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLAYINKA
Authorized Official - Middle Name:JOSEPHINE
Authorized Official - Last Name:AKINNUOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-535-8419
Mailing Address - Street 1:4702 SOMERSET RD
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1132
Mailing Address - Country:US
Mailing Address - Phone:202-535-8419
Mailing Address - Fax:
Practice Address - Street 1:6201 GREENBELT RD
Practice Address - Street 2:
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2354
Practice Address - Country:US
Practice Address - Phone:240-535-8419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR136194261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center