Provider Demographics
NPI:1326302506
Name:BADEMOSI, SADE
Entity Type:Individual
Prefix:MISS
First Name:SADE
Middle Name:
Last Name:BADEMOSI
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 1:13109 LARCHDALE RD
Mailing Address - Street 2:APT 2
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1736
Mailing Address - Country:US
Mailing Address - Phone:240-504-2951
Mailing Address - Fax:
Practice Address - Street 1:13109 LARCHDALE RD
Practice Address - Street 2:APT 2
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1736
Practice Address - Country:US
Practice Address - Phone:240-504-2951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide