Provider Demographics
NPI:1477192649
Name:AJAYI, MUJIDAT YINKA
Entity Type:Individual
Prefix:
First Name:MUJIDAT
Middle Name:YINKA
Last Name:AJAYI
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 1:3502 HUBBARD RD APT 104
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2064
Mailing Address - Country:US
Mailing Address - Phone:240-714-7241
Mailing Address - Fax:
Practice Address - Street 1:3502 HUBBARD RD APT 104
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-2064
Practice Address - Country:US
Practice Address - Phone:240-714-7241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-05
Last Update Date:2020-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14547374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide