Healthcare Provider Details

I. General information

NPI: 1679787667
Provider Name (Legal Business Name): TOSIN OLOWU OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 E 23RD ST
NEW YORK NY
10010-4516
US

IV. Provider business mailing address

326 WASHINGTON ST.
RAHWAY NJ
07065
US

V. Phone/Fax

Practice location:
  • Phone: 212-677-7400
  • Fax:
Mailing address:
  • Phone: 732-428-4452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number013680
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: