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1386806636 NPI number — OYINDAMOLA ABIMBOLA OMIJE MD

NPI Number: 1386806636
Health Care Provider/Practitioner: OYINDAMOLA ABIMBOLA OMIJE MD

Information about “1386806636” NPI (OYINDAMOLA ABIMBOLA OMIJE MD) exists in 1386806636 in HTML format HTML  |  1386806636 in plain Text format TXT  |  1386806636 in PDF (Portable Document Format) PDF  |  1386806636 in an XML format XML  formats.

NPI Number : 1386806636 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1386806636",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "OMIJE",
    "FirstName": "OYINDAMOLA",
    "MiddleName": "ABIMBOLA",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "AMAO",
    "OtherFirstName": "OYINDAMOLA",
    "OtherMiddleName": "ABIMBOLA",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "M.D",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "601 MEMORY LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "YORK",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "17402-2231",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "717-851-1405",
    "MailingAddressFaxNumber": "717-851-6969",
    "FirstLinePracticeLocationAddress": "283 S BUTLER RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LEBANON",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "17042-8939",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "717-273-8871",
    "PracticeLocationAddressFaxNumber": "717-270-2429",
    "EnumerationDate": "06/27/2008",
    "LastUpdateDate": "08/08/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2084P0800X",
          "TaxonomyName": "Psychiatry Physician",
          "LicenseNumber": "MD447848",
          "LicenseNumberStateCode": "PA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084P0804X",
          "TaxonomyName": "Child & Adolescent Psychiatry Physician",
          "LicenseNumber": "MD447848",
          "LicenseNumberStateCode": "PA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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