Provider Demographics
NPI:1417201740
Name:ADEYEMO, TOSIN
Entity Type:Individual
Prefix:
First Name:TOSIN
Middle Name:
Last Name:ADEYEMO
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 1:3401 DODGE PARK RD
Mailing Address - Street 2:APT#201
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2004
Mailing Address - Country:US
Mailing Address - Phone:240-780-6176
Mailing Address - Fax:
Practice Address - Street 1:3401 DODGE PARK RD
Practice Address - Street 2:APT#201
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-2004
Practice Address - Country:US
Practice Address - Phone:240-780-6176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide