MEDICARE: SIMON OLAOYE DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT03792	RI

General Provider Information

NPI Number	:	1760240865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMON OLAOYE DPT

Provider Business Mailing Address
First Line	:	5835 POST RD STE 112
Second Line	:
City	:	EAST GREENWICH
State	:	RI
Zip	:	02818-2154
Country	:	US
Telephone Number	:	401-885-0051
Fax Number	:

Provider Business Practice Location Address
First Line	:	5835 POST RD STE 112
Second Line	:
City	:	EAST GREENWICH
State	:	RI
Zip	:	02818-2154
Country	:	US
Telephone Number	:	401-885-0051
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2024
Last Update Date	:	03/15/2024

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Directions to “ SIMON OLAOYE DPT” Practice Location

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