Provider Demographics
NPI:1922348283
Name:OSUJI, BLAISE OGECHI
Entity Type:Individual
Prefix:
First Name:BLAISE
Middle Name:OGECHI
Last Name:OSUJI
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 1:3269 QUEENSTOWN DR
Mailing Address - Street 2:APT 301
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712
Mailing Address - Country:US
Mailing Address - Phone:240-381-1923
Mailing Address - Fax:
Practice Address - Street 1:3269 QUEENSTOWN DR
Practice Address - Street 2:APT 301
Practice Address - City:MOUNT RAINIER
Practice Address - State:MD
Practice Address - Zip Code:20712
Practice Address - Country:US
Practice Address - Phone:240-381-1923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide