Provider Demographics
NPI:1992959159
Name:SHOYINKA, PAUL (DPT)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:SHOYINKA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3528 80TH ST APT 52
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-4972
Mailing Address - Country:US
Mailing Address - Phone:347-724-0141
Mailing Address - Fax:
Practice Address - Street 1:3528 80TH ST APT 52
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-4972
Practice Address - Country:US
Practice Address - Phone:347-724-0141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0239412251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics