Provider Demographics
NPI:1063719961
Name:OLADOSU, OLUWATOYIN (NP)
Entity type:Individual
Prefix:MRS
First Name:OLUWATOYIN
Middle Name:
Last Name:OLADOSU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 BLUE HILLS PKWY
Mailing Address - Street 2:APT # 1
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-1523
Mailing Address - Country:US
Mailing Address - Phone:617-818-2784
Mailing Address - Fax:
Practice Address - Street 1:1400 COMPUTER DR STE 301
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1790
Practice Address - Country:US
Practice Address - Phone:617-420-5316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-12
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS40880771363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily