Provider Demographics
NPI:1942574231
Name:AYO, OBEHI (RN)
Entity Type:Individual
Prefix:
First Name:OBEHI
Middle Name:
Last Name:AYO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15330 89TH AVE
Mailing Address - Street 2:APT 829
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3821
Mailing Address - Country:US
Mailing Address - Phone:718-974-4979
Mailing Address - Fax:
Practice Address - Street 1:15330 89TH AVE
Practice Address - Street 2:APT 829
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3821
Practice Address - Country:US
Practice Address - Phone:718-974-4979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-03
Last Update Date:2012-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY592376163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse