Provider Demographics
NPI:1942569546
Name:AWAYE, OLUKAYODE
Entity type:Individual
Prefix:
First Name:OLUKAYODE
Middle Name:
Last Name:AWAYE
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 1:950 RUTLAND RD APT 522
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-1515
Mailing Address - Country:US
Mailing Address - Phone:646-642-9413
Mailing Address - Fax:
Practice Address - Street 1:950 RUTLAND RD APT 522
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-1515
Practice Address - Country:US
Practice Address - Phone:646-642-9413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290485164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse