Individual
AYODELE FAYEMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30 MAXI CT # 2, STATEN ISLAND, NY 10304-5201
(718) 815-3205
Mailing address
30 MAXI CT # 2, STATEN ISLAND, NY 10304-5201
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10307589
NY
Other
Enumeration date
11/10/2011
Last updated
11/10/2011
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