Provider Demographics
NPI:1619380292
Name:ADEBAYO-OLOJO, ESTHER (PHD, MS RPH)
Entity Type:Individual
Prefix:DR
First Name:ESTHER
Middle Name:
Last Name:ADEBAYO-OLOJO
Suffix:
Gender:F
Credentials:PHD, MS RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 BROADWAY
Mailing Address - Street 2:RIO DRUGS
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-3558
Mailing Address - Country:US
Mailing Address - Phone:718-599-1172
Mailing Address - Fax:718-599-3073
Practice Address - Street 1:8715 165TH ST
Practice Address - Street 2:4G
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3558
Practice Address - Country:US
Practice Address - Phone:718-658-3953
Practice Address - Fax:718-658-3953
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039106183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist