Provider Demographics
NPI:1467863886
Name:ONIGBOGI, FOLASHADE PRECIOUS
Entity Type:Individual
Prefix:
First Name:FOLASHADE
Middle Name:PRECIOUS
Last Name:ONIGBOGI
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 1:5504 NEWTON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1157
Mailing Address - Country:US
Mailing Address - Phone:240-413-0409
Mailing Address - Fax:
Practice Address - Street 1:5504 NEWTON ST APT2
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784
Practice Address - Country:US
Practice Address - Phone:240-413-0409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA10461253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care