Provider Demographics
NPI:1386519460
Name:FAKIYESI, OLADIPUPO REMILEKUN (MPH)
Entity type:Individual
Prefix:
First Name:OLADIPUPO
Middle Name:REMILEKUN
Last Name:FAKIYESI
Suffix:
Gender:F
Credentials:MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 CARMEN DR
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-3545
Mailing Address - Country:US
Mailing Address - Phone:610-803-6570
Mailing Address - Fax:215-543-4556
Practice Address - Street 1:713 CARMEN DR
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3545
Practice Address - Country:US
Practice Address - Phone:610-803-6570
Practice Address - Fax:215-543-4556
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty