Provider Demographics
NPI:1568061638
Name:FALAIYE, TOYIN O
Entity Type:Individual
Prefix:
First Name:TOYIN
Middle Name:O
Last Name:FALAIYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 ELLIS AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-4439
Mailing Address - Country:US
Mailing Address - Phone:973-277-1021
Mailing Address - Fax:
Practice Address - Street 1:267 ELLIS AVE APT 3
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-4439
Practice Address - Country:US
Practice Address - Phone:973-277-1021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker