Provider Demographics
NPI:1902695109
Name:OLADIMEJI, OLUSHOLA FLORENCE
Entity type:Individual
Prefix:
First Name:OLUSHOLA
Middle Name:FLORENCE
Last Name:OLADIMEJI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 RICHMOND TER
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-1105
Mailing Address - Country:US
Mailing Address - Phone:347-285-4600
Mailing Address - Fax:347-285-4600
Practice Address - Street 1:1804 RICHMOND TER
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-1105
Practice Address - Country:US
Practice Address - Phone:347-285-4600
Practice Address - Fax:347-285-4600
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14937374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula