Basic Information
| Provider Information | |||||||||
| NPI: | 1417483447 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | OYENIRAN | ||||||||
| FirstName: | ENNY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 OLD YORK RD | ||||||||
| Address2: | DEPARTMENT OF MEDICINE - 2 ELKINS | ||||||||
| City: | ABINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190013720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154812191 | ||||||||
| FaxNumber: | 2154814361 | ||||||||
| Practice Location | |||||||||
| Address1: | 23 W PALISADE AVE | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076312705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2014084441 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2017 | ||||||||
| LastUpdateDate: | 10/19/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MT213116 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207W00000X | 25MA11549700 | NJ | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.