Provider Demographics
NPI:1790040871
Name:ADEPOJU, LUCY BOLA
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:BOLA
Last Name:ADEPOJU
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 1:3450 TOLEDO TERRACE
Mailing Address - Street 2:APT. #415
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782
Mailing Address - Country:US
Mailing Address - Phone:202-403-4201
Mailing Address - Fax:
Practice Address - Street 1:3450 TOLEDO TERRACE
Practice Address - Street 2:APT. #415
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782
Practice Address - Country:US
Practice Address - Phone:202-403-4201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide