Basic Information
| Provider Information | |||||||||
| NPI: | 1710238258 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BABALOLA | ||||||||
| FirstName: | ABIODUN | ||||||||
| MiddleName: | OLAJIDE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3500 KINGSLEY CT | ||||||||
| Address2: | UNIT B | ||||||||
| City: | PASADENA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211226654 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2404858964 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6856 EASTERN AVE NW | ||||||||
| Address2: | SUITE 350 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200122165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2025450211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2012 | ||||||||
| LastUpdateDate: | 09/24/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 374U00000X | Y | Nursing Service Related Providers | Home Health Aide |
No ID Information.