Provider Demographics
NPI:1881455376
Name:OLALEYE, FARIDA
Entity type:Individual
Prefix:
First Name:FARIDA
Middle Name:
Last Name:OLALEYE
Suffix:
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 1:46 BRIDGER BLVD
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722-3659
Mailing Address - Country:US
Mailing Address - Phone:347-372-3789
Mailing Address - Fax:
Practice Address - Street 1:46 BRIDGER BLVD
Practice Address - Street 2:
Practice Address - City:CENTRAL ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11722-3659
Practice Address - Country:US
Practice Address - Phone:347-372-3789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician