Provider Demographics
NPI:1134482516
Name:AJAYI, ABIOLA ADENIKE
Entity Type:Individual
Prefix:
First Name:ABIOLA
Middle Name:ADENIKE
Last Name:AJAYI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABIOLA
Other - Middle Name:ADENIKE
Other - Last Name:AJAYI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5544 KAREN ELAINE DR APT 1527
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-4157
Mailing Address - Country:US
Mailing Address - Phone:240-515-9651
Mailing Address - Fax:
Practice Address - Street 1:1822 JEFFERSON PL NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-2505
Practice Address - Country:US
Practice Address - Phone:240-515-9651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1134482516Medicaid