Basic Information
| Provider Information | |||||||||
| NPI: | 1871852038 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OSAGIE | ||||||||
| FirstName: | FOLASADE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 406N MAIN ST 170 | ||||||||
| Address2: | |||||||||
| City: | EAST LONGMEADOW | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010281850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6172443322 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2139 GEORGIA AVE NW | ||||||||
| Address2: | SUITE 3B | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200013035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028651452 | ||||||||
| FaxNumber: | 2028657202 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2012 | ||||||||
| LastUpdateDate: | 06/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 264828 | MA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 054458 | CT | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.