Provider Demographics
NPI:1710499520
Name:ONIYIDE, MUSOLA NINILOLA ALFRED (DPT)
Entity Type:Individual
Prefix:
First Name:MUSOLA
Middle Name:NINILOLA ALFRED
Last Name:ONIYIDE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 FREDERICK TER
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-1319
Mailing Address - Country:US
Mailing Address - Phone:917-892-5840
Mailing Address - Fax:
Practice Address - Street 1:16 FREDERICK TER
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-1319
Practice Address - Country:US
Practice Address - Phone:917-892-5840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist