Provider Demographics
NPI:1245479096
Name:OBAYOMI, YETUNDE MORENIKEJI (RPH)
Entity type:Individual
Prefix:MISS
First Name:YETUNDE
Middle Name:MORENIKEJI
Last Name:OBAYOMI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 E 141ST ST APT 1B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-2333
Mailing Address - Country:US
Mailing Address - Phone:646-314-1169
Mailing Address - Fax:
Practice Address - Street 1:1998 BRUCKNER BLVD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2500
Practice Address - Country:US
Practice Address - Phone:718-239-4428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist