Provider Demographics
NPI:1760240865
Name:OLAOYE, SIMON (DPT)
Entity Type:Individual
Prefix:
First Name:SIMON
Middle Name:
Last Name:OLAOYE
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 1:5835 POST RD STE 112
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-2154
Mailing Address - Country:US
Mailing Address - Phone:401-885-0051
Mailing Address - Fax:
Practice Address - Street 1:5835 POST RD STE 112
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-2154
Practice Address - Country:US
Practice Address - Phone:401-885-0051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT03792225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist