IndividualActive
Abidemi Omoyefa
NPI 1497445068 · Prosthetic/Orthotic Supplier · Staten Island, NY
Provider details
- NPI number
- 1497445068
- Entity type
- Individual
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 510765 (NY)
Specialties & taxonomies
Suppliers
Practice location
1324 Forest Ave Ste 104
Staten Island, NY 10302-2044
Phone: (347) 791-9818
Approximate (ZIP-level) locationGet directions
Mailing address
1324 Forest Ave Ste 104
Staten Island, NY 10302-2044
Registry dates
- Enumerated
- 2023-05-08
- Last updated
- 2023-05-08
- Certified
- 2023-05-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.