Provider Demographics
NPI:1790249027
Name:ONI, OLAYINKA ABISOLA I
Entity Type:Individual
Prefix:MISS
First Name:OLAYINKA
Middle Name:ABISOLA
Last Name:ONI
Suffix:I
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 1:858 E 29TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-2927
Mailing Address - Country:US
Mailing Address - Phone:718-859-4500
Mailing Address - Fax:
Practice Address - Street 1:765 LINCOLN AVE APT 12U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-4162
Practice Address - Country:US
Practice Address - Phone:718-859-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator