Provider Demographics
NPI:1710238258
Name:BABALOLA, ABIODUN OLAJIDE
Entity Type:Individual
Prefix:
First Name:ABIODUN
Middle Name:OLAJIDE
Last Name:BABALOLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 KINGSLEY CT
Mailing Address - Street 2:UNIT B
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-6654
Mailing Address - Country:US
Mailing Address - Phone:240-485-8964
Mailing Address - Fax:
Practice Address - Street 1:6856 EASTERN AVE NW
Practice Address - Street 2:SUITE 350
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2165
Practice Address - Country:US
Practice Address - Phone:202-545-0211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide