Provider Demographics
NPI:1861639056
Name:ARIYO, ABISOYE O (DPT)
Entity Type:Individual
Prefix:
First Name:ABISOYE
Middle Name:O
Last Name:ARIYO
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 1:795 PARKWAY AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-2704
Mailing Address - Country:US
Mailing Address - Phone:862-781-3500
Mailing Address - Fax:732-863-1707
Practice Address - Street 1:795 PARKWAY AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-2704
Practice Address - Country:US
Practice Address - Phone:862-781-3500
Practice Address - Fax:732-863-1707
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQAO4756225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ050883RKDMedicare PIN