Provider Demographics
NPI:1811144322
Name:AYENI, OLUFEMI (MD)
Entity type:Individual
Prefix:DR
First Name:OLUFEMI
Middle Name:
Last Name:AYENI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E 71ST ST
Mailing Address - Street 2:10 V
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4808
Mailing Address - Country:US
Mailing Address - Phone:646-203-6029
Mailing Address - Fax:
Practice Address - Street 1:400 E 71ST ST
Practice Address - Street 2:10 V
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4808
Practice Address - Country:US
Practice Address - Phone:646-203-6029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP62200207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine