Provider Demographics
NPI:1427793579
Name:FADAHUNSI, TOLULOPE
Entity type:Individual
Prefix:
First Name:TOLULOPE
Middle Name:
Last Name:FADAHUNSI
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 1:20 FULTON RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-2326
Mailing Address - Country:US
Mailing Address - Phone:908-239-6512
Mailing Address - Fax:
Practice Address - Street 1:84 VERONICA AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3529
Practice Address - Country:US
Practice Address - Phone:732-659-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist