Provider Demographics
NPI:1609566819
Name:BADRU, COMFORT OLAPEJU II
Entity Type:Individual
Prefix:
First Name:COMFORT
Middle Name:OLAPEJU
Last Name:BADRU
Suffix:II
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 1:11306 CORINTHIAN CT
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-5515
Mailing Address - Country:US
Mailing Address - Phone:124-061-4659
Mailing Address - Fax:
Practice Address - Street 1:9500 ANNAPOLIS RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2060
Practice Address - Country:US
Practice Address - Phone:301-850-1148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician