Provider Demographics
NPI:1629724240
Name:OSENI, ABIDEMI O
Entity Type:Individual
Prefix:
First Name:ABIDEMI
Middle Name:O
Last Name:OSENI
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 1:8619 HAYSHED LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2604
Mailing Address - Country:US
Mailing Address - Phone:954-662-8549
Mailing Address - Fax:
Practice Address - Street 1:5585 TWIN KNOLLS RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3245
Practice Address - Country:US
Practice Address - Phone:410-730-2789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist