Basic Information
| Provider Information | |||||||||
| NPI: | 1669608691 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AJAYI | ||||||||
| FirstName: | FADEKE | ||||||||
| MiddleName: | OYENIKE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2301 E ALLEGHENY AVE | ||||||||
| Address2: | 180 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191344427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159263700 | ||||||||
| FaxNumber: | 2159263703 | ||||||||
| Practice Location | |||||||||
| Address1: | 2301 E ALLEGHENY AVE | ||||||||
| Address2: | 180 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191344427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159263700 | ||||||||
| FaxNumber: | 2159263703 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2009 | ||||||||
| LastUpdateDate: | 11/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MD449595 | PA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 597586 | 01 | PA | TPI MEDICARE GROUP | OTHER | CD4829 | 01 | PA | TPI RAILROAD MEDICARE | OTHER | 1007278000 | 01 | PA | TPI MEDICAID GROUP | OTHER |