Provider Demographics
NPI:1942561378
Name:BELLO-IMMAM, KAFILAT FOLASHADE
Entity Type:Individual
Prefix:MRS
First Name:KAFILAT
Middle Name:FOLASHADE
Last Name:BELLO-IMMAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAFILAT
Other - Middle Name:FOLASHADE
Other - Last Name:AROWOLO-OLAIYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:305 JO DRIVE
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774
Mailing Address - Country:US
Mailing Address - Phone:240-413-4242
Mailing Address - Fax:
Practice Address - Street 1:305 JO DRIVE
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774
Practice Address - Country:US
Practice Address - Phone:240-413-4248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide