Provider Demographics
NPI:1922347202
Name:ADENIYI, ADEMOLA E
Entity Type:Individual
Prefix:
First Name:ADEMOLA
Middle Name:E
Last Name:ADENIYI
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 1:6921 SCOTCH DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5320
Mailing Address - Country:US
Mailing Address - Phone:443-938-6888
Mailing Address - Fax:
Practice Address - Street 1:6921 SCOTCH DR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5320
Practice Address - Country:US
Practice Address - Phone:443-938-6888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide