Provider Demographics
NPI:1962662544
Name:OJIFINNI, TAYE J
Entity Type:Individual
Prefix:
First Name:TAYE
Middle Name:J
Last Name:OJIFINNI
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 1:9305 ISPAHAN LOOP
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-2873
Mailing Address - Country:US
Mailing Address - Phone:410-963-4080
Mailing Address - Fax:
Practice Address - Street 1:3385 CRAIN HWY
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4857
Practice Address - Country:US
Practice Address - Phone:301-396-4517
Practice Address - Fax:301-396-4637
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17581183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist