Provider Demographics
NPI:1285526996
Name:AWOLU, OLAYINKA OLUBUNMI
Entity type:Individual
Prefix:
First Name:OLAYINKA
Middle Name:OLUBUNMI
Last Name:AWOLU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 AMITY PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10303-1705
Mailing Address - Country:US
Mailing Address - Phone:347-265-9021
Mailing Address - Fax:347-265-9021
Practice Address - Street 1:79 AMITY PL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10303-1705
Practice Address - Country:US
Practice Address - Phone:347-265-9021
Practice Address - Fax:347-265-9021
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY352844164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse