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General NPI Number Information
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NPI Number | 1609299502
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Entity Type | Individual
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Provider Name | THAOFIQ OLATUNDE IJAIYA
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Gender | Male
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Dates
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Enumeration Date | 01/28/2014
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 329 WHITE PLAINS RD STE 100
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City | EASTCHESTER
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State | NY
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Zip | 10709-2908
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Country | US
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Telephone | 914-337-1610
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Fax | 914-337-9312
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Provider Business Mailing Address
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Address Line | 329 WHITE PLAINS RD STE 100
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City | EASTCHESTER
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State | NY
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Zip | 10709-2908
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Country | US
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Telephone | 914-337-1610
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Fax | 914-337-9312
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 286661
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License Number State | NY
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