Provider Demographics
NPI:1073292843
Name:OLAJUYIN, ABOSEDE CELINAH
Entity Type:Individual
Prefix:MS
First Name:ABOSEDE
Middle Name:CELINAH
Last Name:OLAJUYIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10209 RUNNING BROOK LN UPPR MARLBORO
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-6657
Mailing Address - Country:US
Mailing Address - Phone:301-364-8916
Mailing Address - Fax:
Practice Address - Street 1:10209 RUNNING BROOK LN UPPR MARLBORO
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-6657
Practice Address - Country:US
Practice Address - Phone:130-185-1942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00182475376K00000X
MDCNA20192136374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide