Provider Demographics
NPI:1497636310
Name:OKUFUWA, AKINTUNDE OLORUNLEKE
Entity type:Individual
Prefix:
First Name:AKINTUNDE
Middle Name:OLORUNLEKE
Last Name:OKUFUWA
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 1:497 N MAIN ST APT 3
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-6701
Mailing Address - Country:US
Mailing Address - Phone:978-552-9703
Mailing Address - Fax:
Practice Address - Street 1:497 N MAIN ST APT 3
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-6701
Practice Address - Country:US
Practice Address - Phone:978-552-9703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA001867315374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty