Provider Demographics
NPI:1659031649
Name:AKINFEMI, TEMITAYO
Entity Type:Individual
Prefix:
First Name:TEMITAYO
Middle Name:
Last Name:AKINFEMI
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 1:1150 FIRST AVE STE 511
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1316
Mailing Address - Country:US
Mailing Address - Phone:347-495-4376
Mailing Address - Fax:
Practice Address - Street 1:1150 FIRST AVE STE 511
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1316
Practice Address - Country:US
Practice Address - Phone:347-495-4376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-18
Last Update Date:2021-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN301697164W00000X
DEL2-0024194164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse