Provider Demographics
NPI:1649854902
Name:OLA, DAVID OLAYINKA
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:OLAYINKA
Last Name:OLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:OLAYINKA
Other - Middle Name:
Other - Last Name:OLADIPUPO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:530 1ST AVE # 3W29A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:212-263-2494
Mailing Address - Fax:
Practice Address - Street 1:530 1ST AVE # 3W29A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-2494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2022-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program