Provider Demographics
NPI:1114496015
Name:LAJORIN, COMFORT OLUBUKOLA (HOME HEALTH AIDE)
Entity Type:Individual
Prefix:
First Name:COMFORT
Middle Name:OLUBUKOLA
Last Name:LAJORIN
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:COMFORT
Other - Middle Name:OLUBUKOLA
Other - Last Name:LAJORIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HOME HEALTH AIDE
Mailing Address - Street 1:3908 53RD PL APT 302
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1134
Mailing Address - Country:US
Mailing Address - Phone:240-714-1304
Mailing Address - Fax:
Practice Address - Street 1:3908 53RD PL APT 302
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-1134
Practice Address - Country:US
Practice Address - Phone:240-714-1304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14154374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide