Provider Demographics
NPI:1609299502
Name:IJAIYA, THAOFIQ OLATUNDE
Entity type:Individual
Prefix:
First Name:THAOFIQ
Middle Name:OLATUNDE
Last Name:IJAIYA
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 1:329 WHITE PLAINS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-2908
Mailing Address - Country:US
Mailing Address - Phone:914-337-1610
Mailing Address - Fax:914-337-9312
Practice Address - Street 1:329 WHITE PLAINS RD STE 100
Practice Address - Street 2:
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709-2908
Practice Address - Country:US
Practice Address - Phone:914-337-1610
Practice Address - Fax:914-337-9312
Is Sole Proprietor?:No
Enumeration Date:2014-01-28
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286661207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease