Provider Demographics
NPI:1679835854
Name:ANINYE, OLAWUNMI O (SPECIAL INSTRUCTION)
Entity Type:Individual
Prefix:
First Name:OLAWUNMI
Middle Name:O
Last Name:ANINYE
Suffix:
Gender:F
Credentials:SPECIAL INSTRUCTION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133-17 226TH STREET
Mailing Address - Street 2:
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413
Mailing Address - Country:US
Mailing Address - Phone:718-756-6321
Mailing Address - Fax:
Practice Address - Street 1:13317 226TH ST
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-1735
Practice Address - Country:US
Practice Address - Phone:718-756-6321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY621002121174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist