Provider Demographics
NPI:1093385429
Name:ALADE, OLUWATOSIN MARIAN
Entity Type:Individual
Prefix:
First Name:OLUWATOSIN
Middle Name:MARIAN
Last Name:ALADE
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 1:30B PINE HILL RD
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-2036
Mailing Address - Country:US
Mailing Address - Phone:508-304-0790
Mailing Address - Fax:
Practice Address - Street 1:30B PINE HILL RD
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-2036
Practice Address - Country:US
Practice Address - Phone:508-304-0790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2352146163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse