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Individual

DR. ALFRED O FAYEMI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
308 WILLOW AVE., HOBOKEN, NJ 07030-3808
(201) 418-1420
(201) 418-1983
Mailing address
4567 CROSSROADS PARK DR, LIVERPOOL, NY 13088-3589
(315) 295-2100
(315) 454-0136

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
25MA02999400
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0246906
NJ
Enumeration date
11/22/2006
Last updated
01/18/2012
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