Provider Demographics
NPI:1568610947
Name:BOYO-BANKOLE, OLAYINKA P
Entity Type:Individual
Prefix:MRS
First Name:OLAYINKA
Middle Name:P
Last Name:BOYO-BANKOLE
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 1:12216 172ND ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-2625
Mailing Address - Country:US
Mailing Address - Phone:718-525-5022
Mailing Address - Fax:
Practice Address - Street 1:12216 172ND ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-2625
Practice Address - Country:US
Practice Address - Phone:718-525-5022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker