Provider Demographics
NPI:1730707241
Name:SAIBU, SHERIFAT OLUWATOYIN (RN)
Entity type:Individual
Prefix:
First Name:SHERIFAT
Middle Name:OLUWATOYIN
Last Name:SAIBU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 BERKELEY AVE
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-1903
Mailing Address - Country:US
Mailing Address - Phone:631-834-8347
Mailing Address - Fax:631-638-5038
Practice Address - Street 1:127 BERKELEY AVE
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-1903
Practice Address - Country:US
Practice Address - Phone:631-834-8347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY775466163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse