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General NPI Number Information
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NPI Number | 1336552272
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Entity Type | Individual
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Provider Name | ABIODUN SIKIRU AWOLESI MPT
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Gender | Male
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Dates
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Enumeration Date | 06/09/2014
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Last Update Date | 06/09/2014
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Provider Practice Location Address
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Address Line | 510 PHEASANT HOLLOW DR
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City | PLAINSBORO
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State | NJ
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Zip | 08536-2110
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Country | US
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Telephone | 609-606-2052
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8611
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City | TRENTON
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State | NJ
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Zip | 08650-0611
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Country | US
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Telephone | 609-510-4931
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA00718400
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License Number State | NJ
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