Provider Demographics
NPI:1912785981
Name:WILLIAMS, OYINDAMOLA RHEOBOTH
Entity Type:Individual
Prefix:
First Name:OYINDAMOLA
Middle Name:RHEOBOTH
Last Name:WILLIAMS
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 1:35 LESLIE RD UNIT F
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-2049
Mailing Address - Country:US
Mailing Address - Phone:475-345-2552
Mailing Address - Fax:
Practice Address - Street 1:35 LESLIE RD UNIT F
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-2049
Practice Address - Country:US
Practice Address - Phone:475-345-2552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program