Provider Demographics
NPI:1356116933
Name:AKINSANYA, OLUTUNDE DIRAN
Entity type:Individual
Prefix:
First Name:OLUTUNDE
Middle Name:DIRAN
Last Name:AKINSANYA
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 1:23 EARL ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07114-1792
Mailing Address - Country:US
Mailing Address - Phone:862-298-1951
Mailing Address - Fax:
Practice Address - Street 1:23 EARL ST APT 2
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07114-1792
Practice Address - Country:US
Practice Address - Phone:862-298-1951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)