1326303702 NPI number — MRS. OLAYINKA ENIOLA DARE SPECIAL INSTRUCTION

Table of content: MRS. OLAYINKA ENIOLA DARE SPECIAL INSTRUCTION (NPI 1326303702)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326303702 NPI number — MRS. OLAYINKA ENIOLA DARE SPECIAL INSTRUCTION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DARE
Provider First Name:
OLAYINKA
Provider Middle Name:
ENIOLA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
SPECIAL INSTRUCTION
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326303702
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1035 BAY 30TH ST
Provider Second Line Business Mailing Address:
FARROCKAWAY
Provider Business Mailing Address City Name:
FAR ROCKAWAY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11691-1843
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-471-4995
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1035 BAY 30TH STREET
Provider Second Line Business Practice Location Address:
FARROCKAWAY
Provider Business Practice Location Address City Name:
QUEENS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11691
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-471-4995
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/11/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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