Provider Demographics
NPI:1235578063
Name:ONIGBOGI, TEMITOPE
Entity Type:Individual
Prefix:
First Name:TEMITOPE
Middle Name:
Last Name:ONIGBOGI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 NICHOLSON ST
Mailing Address - Street 2:#304
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782
Mailing Address - Country:US
Mailing Address - Phone:301-454-9831
Mailing Address - Fax:
Practice Address - Street 1:2717 NICHOLSON ST
Practice Address - Street 2:#304
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782
Practice Address - Country:US
Practice Address - Phone:301-454-9831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide