Provider Demographics
NPI:1154688463
Name:ADESANYA, ABIODUN F
Entity Type:Individual
Prefix:
First Name:ABIODUN
Middle Name:F
Last Name:ADESANYA
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 1:6739 RIVERDALE RD
Mailing Address - Street 2:APT#D
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1769
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6739 RIVERDALE RD
Practice Address - Street 2:APT#D
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1769
Practice Address - Country:US
Practice Address - Phone:202-722-1725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide