Provider Demographics
NPI:1467091835
Name:AYORINDE, AYODIRAN
Entity type:Individual
Prefix:
First Name:AYODIRAN
Middle Name:
Last Name:AYORINDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 CONCETTA DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT ROYAL
Mailing Address - State:NJ
Mailing Address - Zip Code:08061-1113
Mailing Address - Country:US
Mailing Address - Phone:856-287-1289
Mailing Address - Fax:856-295-9516
Practice Address - Street 1:45 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:ALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08001-1004
Practice Address - Country:US
Practice Address - Phone:856-935-1555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251F00000X
NJ26NJ15293600363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No251F00000XAgenciesHome Infusion