Provider Demographics
NPI:1356791842
Name:MOGAJI, MORILIAT
Entity type:Individual
Prefix:
First Name:MORILIAT
Middle Name:
Last Name:MOGAJI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 SAGAMORE DR
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-2313
Mailing Address - Country:US
Mailing Address - Phone:216-559-1962
Mailing Address - Fax:
Practice Address - Street 1:1821 SAGAMORE DR
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-2313
Practice Address - Country:US
Practice Address - Phone:216-559-1962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH419259163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse