Provider Demographics
NPI:1760034680
Name:AFOLAYAN-OLOYE, OLABISI ISRAT (MD)
Entity Type:Individual
Prefix:DR
First Name:OLABISI
Middle Name:ISRAT
Last Name:AFOLAYAN-OLOYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4238
Mailing Address - Country:US
Mailing Address - Phone:215-662-4829
Mailing Address - Fax:215-614-1856
Practice Address - Street 1:3600 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4211
Practice Address - Country:US
Practice Address - Phone:215-662-4829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT227663207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematologyGroup - Multi-Specialty