Provider Demographics
NPI:1952665630
Name:SANYA, OLAJIDE
Entity Type:Individual
Prefix:MR
First Name:OLAJIDE
Middle Name:
Last Name:SANYA
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 1:11442 HORSE SOLDIER PL
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1432
Mailing Address - Country:US
Mailing Address - Phone:540-659-5028
Mailing Address - Fax:
Practice Address - Street 1:11442 HORSE SOLDIER PL
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-1432
Practice Address - Country:US
Practice Address - Phone:540-659-5028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide