Provider Demographics
NPI:1679335574
Name:AKINLUYI, AUGUSTINE OLUWATUYI
Entity type:Individual
Prefix:
First Name:AUGUSTINE
Middle Name:OLUWATUYI
Last Name:AKINLUYI
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 1:8614 LAVERNE DR
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-1732
Mailing Address - Country:US
Mailing Address - Phone:240-854-9714
Mailing Address - Fax:
Practice Address - Street 1:2500 MARKHAM LN APT 2
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-2661
Practice Address - Country:US
Practice Address - Phone:412-391-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator