Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Azeezat Omobolanle Ajao

Individual provider Physical Therapist · NPI 1225904600

Azeezat Omobolanle Ajao is a Physical Therapist in Private Practice in Bronx, New York. Qualified in 2018, 8 years ago. Practices as a sole proprietor. Licensed in New York.

Years since qualifying
8
Licensed in
NY
In the registry since
2025
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Practice location Address checks out

3132 Kingsland Ave
Bronx, NY 10469
Phone: (618) 477-4186
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 055104 (NY)

Record details

NPI number1225904600
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 14, 2025
Last updated in NPPESOctober 14, 2025
Certification dateOctober 14, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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