Provider Demographics
NPI:1861959843
Name:BISHOPTON-TAYLOR, AYO
Entity type:Individual
Prefix:
First Name:AYO
Middle Name:
Last Name:BISHOPTON-TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E BETHPAGE RD STE 5
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4228
Mailing Address - Country:US
Mailing Address - Phone:516-731-5588
Mailing Address - Fax:
Practice Address - Street 1:2552 120TH ST APT 3FL
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-1051
Practice Address - Country:US
Practice Address - Phone:551-221-2963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator