Provider Demographics
NPI:1538297585
Name:OJOFEITIMI, OLUWASEYI O (MPT)
Entity Type:Individual
Prefix:MS
First Name:OLUWASEYI
Middle Name:O
Last Name:OJOFEITIMI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:SHEYI
Other - Middle Name:
Other - Last Name:OJOFEITIMI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPT
Mailing Address - Street 1:89 VANDERVEER ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-1712
Mailing Address - Country:US
Mailing Address - Phone:718-246-6379
Mailing Address - Fax:718-246-6383
Practice Address - Street 1:405 W 55TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-4402
Practice Address - Country:US
Practice Address - Phone:212-405-9073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023258225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist