Healthcare Provider Details

I. General information

NPI: 1275358160
Provider Name (Legal Business Name): OLAYINKA SIKIRU OLAOSUN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 11/18/2024
Certification Date: 11/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 KING RICHARD DR
PARMA OH
44134-5425
US

IV. Provider business mailing address

3010 KING RICHARD DR
PARMA OH
44134-5425
US

V. Phone/Fax

Practice location:
  • Phone: 216-632-6812
  • Fax:
Mailing address:
  • Phone: 216-632-6812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: