Healthcare Provider Details

I. General information

NPI: 1225968712
Provider Name (Legal Business Name): OLADOYIN MOTUNRAYO ALABI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 W UNION ST
ASHLAND MA
01721-1420
US

IV. Provider business mailing address

46 DOVER RD
MILLIS MA
02054-1346
US

V. Phone/Fax

Practice location:
  • Phone: 845-200-0491
  • Fax:
Mailing address:
  • Phone: 845-200-0491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN2336364
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberRN2336364
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2336364
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: