Olawale, Ayodeji Bamidele

Olawale, Ayodeji Bamidele is an sole proprietor health care provider with primary practice located at 267 Grant St , Bridgeport CT 06610-2805. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Olawale, Ayodeji Bamidele can be contacted via phone (203) 384-3709.

Contact Information

Primary practice address
267 Grant St Bridgeport CT 06610-2805
Phone: (203) 384-3709
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R210564 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 10362 Connecticut

Profile Details

NPI number 1598395725
LBN Legal business name Olawale, Ayodeji Bamidele
Credentials PMHNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 15th, 2020
Last updated Sep 6th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598395725 NPPES
Connecticut MEDICAID 1598395725

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