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3822 N Elm St Ste 101 Greensboro NC 27455-2596 | |
| (516) 312-5764 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3822 N Elm St Ste 101, Greensboro, North Carolina |
| Authorized Official Name and Position | Mojeed A Akintayo (OWNER/CEO) |
| Authorized Official Contact | 5163125764 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3822 N Elm St Ste 101 Greensboro NC 27455-2596 Ph: (516) 312-5764 | 3822 N Elm St Ste 101 Greensboro NC 27455-2596 Ph: (516) 312-5764 |
| NPI Number | 1497098420 |
|---|---|
| Provider Enumeration Date | 03/27/2013 |
| Last Update Date | 12/04/2024 |
| Certification Date | 12/04/2024 |
| Medicare PECOS PAC ID | 2163665340 |
|---|---|
| Medicare Enrollment ID | O20130909000423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497098420 | NPI | - | NPPES |
| 5911431 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 2009-00549 (North Carolina) | Primary |
| Provider Name | Mojeed A Akintayo |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1093936676 PECOS PAC ID: 5496853251 Enrollment ID: I20090616000223 |
| Provider Name | Musa Akintayo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174151344 PECOS PAC ID: 0749729366 Enrollment ID: I20240827004615 |
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