Provider Demographics
NPI:1861631368
Name:ORIAKHI, AUSTIN OSAMWONYI (LPN)
Entity Type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:OSAMWONYI
Last Name:ORIAKHI
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MONTELLO ST
Mailing Address - Street 2:APT #1
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4089
Mailing Address - Country:US
Mailing Address - Phone:617-388-2988
Mailing Address - Fax:
Practice Address - Street 1:9 MONTELLO ST
Practice Address - Street 2:APT #1
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4089
Practice Address - Country:US
Practice Address - Phone:617-388-2988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-07
Last Update Date:2009-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA68507164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse