Provider Demographics
NPI:1457953317
Name:ABOLAJI, AHMED
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:ABOLAJI
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 1:6201 FRANKLIN BLVD APT 104
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-3101
Mailing Address - Country:US
Mailing Address - Phone:216-456-6524
Mailing Address - Fax:
Practice Address - Street 1:6201 FRANKLIN BLVD APT 104
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-3101
Practice Address - Country:US
Practice Address - Phone:216-456-6524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-14
Last Update Date:2020-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1830102172A00000X, 374U00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No172A00000XOther Service ProvidersDriver
No374U00000XNursing Service Related ProvidersHome Health Aide