Provider Demographics
NPI:1063997203
Name:OJURI, OLAYINKA
Entity type:Individual
Prefix:
First Name:OLAYINKA
Middle Name:
Last Name:OJURI
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 1:686 CHALKSTONE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-4346
Mailing Address - Country:US
Mailing Address - Phone:774-992-4999
Mailing Address - Fax:401-437-6245
Practice Address - Street 1:686 CHALKSTONE AVE APT 2
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-4346
Practice Address - Country:US
Practice Address - Phone:774-992-4999
Practice Address - Fax:401-437-6245
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver