Doctor Name: | MR. AKINOLA MOBOLAJI |
NPI Number: | 1083022594 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSN, APRN, PMHNP-BC |
License Number: | 5788 |
Business Practice Address: | 20 Research Pkwy Old Saybrook, CT - 064754214 |
Business Phone Number: | 8003703651 |
Business Fax Number: | 8605100020 |
Mailing Address: | 20 Research Pkwy, OLD SAYBROOK |
State: | CT |
Postal Code: | 064754214 |
Phone Number: | 8003703651 |
Fax Number: | 8605100020 |
NPI Enumeration Date: | 07/28/2014 |
NPI Last Update Date: | 03/06/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | 5788 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |