Provider Demographics
NPI:1326303702
Name:DARE, OLAYINKA ENIOLA (SPECIAL INSTRUCTION)
Entity Type:Individual
Prefix:MRS
First Name:OLAYINKA
Middle Name:ENIOLA
Last Name:DARE
Suffix:
Gender:F
Credentials:SPECIAL INSTRUCTION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 BAY 30TH ST
Mailing Address - Street 2:FARROCKAWAY
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-1843
Mailing Address - Country:US
Mailing Address - Phone:718-471-4995
Mailing Address - Fax:
Practice Address - Street 1:1035 BAY 30TH STREET
Practice Address - Street 2:FARROCKAWAY
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11691
Practice Address - Country:US
Practice Address - Phone:718-471-4995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist