Provider Demographics
NPI:1437554516
Name:ARIJELOYE, SIADAT IYABODE (MASTER DEGREE EDUCAT)
Entity Type:Individual
Prefix:
First Name:SIADAT
Middle Name:IYABODE
Last Name:ARIJELOYE
Suffix:
Gender:F
Credentials:MASTER DEGREE EDUCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 E 53RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2501
Mailing Address - Country:US
Mailing Address - Phone:718-773-5332
Mailing Address - Fax:
Practice Address - Street 1:133 E 53RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2501
Practice Address - Country:US
Practice Address - Phone:718-773-5332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY733990174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist