Healthcare Provider Details

I. General information

NPI: 1912413220
Provider Name (Legal Business Name): SIKIRU OLAITAN ALABI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2017
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 KENILWORTH AVE NE
WASHINGTON DC
20019-2010
US

IV. Provider business mailing address

2402 BRIGHTSEAT RD APT 6
HYATTSVILLE MD
20785-3541
US

V. Phone/Fax

Practice location:
  • Phone: 202-588-8036
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA13006
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN1009066
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: