Healthcare Provider Details

I. General information

NPI: 1720910656
Provider Name (Legal Business Name): MR. OLUWAYEMI KEHINDE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 1ST AVE BLDG 129
ORANGEBURG NY
10962-1106
US

IV. Provider business mailing address

80 ALEXANDER ST APT 3401
YONKERS NY
10701-5395
US

V. Phone/Fax

Practice location:
  • Phone: 845-680-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberN11703
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: