Provider Demographics
NPI:1003530767
Name:ABIDOYE, PRINCE
Entity Type:Individual
Prefix:
First Name:PRINCE
Middle Name:
Last Name:ABIDOYE
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 1:1305 E 40TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-2902
Mailing Address - Country:US
Mailing Address - Phone:347-481-0226
Mailing Address - Fax:
Practice Address - Street 1:1305 E 40TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-2902
Practice Address - Country:US
Practice Address - Phone:347-481-0226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker