Olaleye A. Ajayi, PT
Individual provider Active NPI Contractor · Orange, NJ
NPI 1871653774 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1871653774
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- PT40QA00831500 (NJ)
- Practice address
- 765 Vose Ave
Apt. B-9
Orange, NJ 07050-1060 - Phone
- (973) 674-1677
- Fax
- (973) 674-6226
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT40QA00831500 | NJ | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | PT40QA00831500 | NJ | Yes |
Addresses
Primary practice location
765 Vose Ave
Apt. B-9
Orange, NJ 07050-1060
Mailing address
765 Vose Ave
Apt. B-9
Orange, NJ 07050-1060
Phone (973) 674-1677
Other providers in Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.