Individual
OLAYIWOLA RAPHAEL ILORI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
2682 WELSH RD, PHILADELPHIA, PA 19152-1548
(267) 210-7121
Mailing address
2682 WELSH RD, PHILADELPHIA, PA 19152-1548
(267) 241-1118
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP025415
PA
Other
Enumeration date
04/14/2022
Last updated
04/14/2022
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