Provider Demographics
NPI:1003182536
Name:BANJOKO, KABIRU (HHA)
Entity Type:Individual
Prefix:
First Name:KABIRU
Middle Name:
Last Name:BANJOKO
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5804 ANNAPOLIS RD
Mailing Address - Street 2:205
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-2076
Mailing Address - Country:US
Mailing Address - Phone:202-545-0935
Mailing Address - Fax:
Practice Address - Street 1:5804 ANNAPOLIS RD
Practice Address - Street 2:205
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-2076
Practice Address - Country:US
Practice Address - Phone:202-545-0935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide