Provider Demographics
NPI:1104679331
Name:AKINMOJU, OLUMIDE DAMILOLA (MD)
Entity type:Individual
Prefix:
First Name:OLUMIDE
Middle Name:DAMILOLA
Last Name:AKINMOJU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 DUBOIS STREET
Mailing Address - Street 2:MONTEFIORE ST. LUKE'S CORNWALL
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550
Mailing Address - Country:US
Mailing Address - Phone:845-561-4400
Mailing Address - Fax:845-568-2614
Practice Address - Street 1:70 DUBOIS STREET
Practice Address - Street 2:MONTEFIORE ST. LUKE'S CORNWALL
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550
Practice Address - Country:US
Practice Address - Phone:845-561-4400
Practice Address - Fax:845-568-2614
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program