Provider Demographics
NPI:1528733607
Name:AKINOLA, PHAYNA M
Entity type:Individual
Prefix:MRS
First Name:PHAYNA
Middle Name:M
Last Name:AKINOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WATERVIEW RD APT E7
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-6356
Mailing Address - Country:US
Mailing Address - Phone:215-866-6565
Mailing Address - Fax:
Practice Address - Street 1:2 WATERVIEW RD APT E7
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-6356
Practice Address - Country:US
Practice Address - Phone:215-866-6565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy