Provider Demographics
NPI:1760268064
Name:TAIWO-ONIGA, OLUWADAMILOLA MUNIRAT (NP)
Entity type:Individual
Prefix:
First Name:OLUWADAMILOLA
Middle Name:MUNIRAT
Last Name:TAIWO-ONIGA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 MEYER AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-3136
Mailing Address - Country:US
Mailing Address - Phone:516-709-4868
Mailing Address - Fax:
Practice Address - Street 1:10816 63RD RD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1352
Practice Address - Country:US
Practice Address - Phone:516-709-4868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY765524163WX0003X
NYF421729-01363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient