Provider Demographics
NPI:1164122321
Name:NYAMALUM, BANIJEOYE LILIAN
Entity Type:Individual
Prefix:
First Name:BANIJEOYE
Middle Name:LILIAN
Last Name:NYAMALUM
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 1:6813 RIVERDALE RD APT L7
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1800
Mailing Address - Country:US
Mailing Address - Phone:202-655-8206
Mailing Address - Fax:
Practice Address - Street 1:6813 RIVERDALE RD APT L7
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1800
Practice Address - Country:US
Practice Address - Phone:202-655-8206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCNA22068251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care