Provider Demographics
NPI:1043985609
Name:ADEBAYO, FOLASADE AMINAT
Entity type:Individual
Prefix:
First Name:FOLASADE
Middle Name:AMINAT
Last Name:ADEBAYO
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 1:3417 DODGE PARK RD APT 303
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2037
Mailing Address - Country:US
Mailing Address - Phone:301-732-2726
Mailing Address - Fax:
Practice Address - Street 1:955 LENFANT PLZ SW STE 985
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-6104
Practice Address - Country:US
Practice Address - Phone:202-895-2828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00179843376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide