Healthcare Provider Details

I. General information

NPI: 1104237452
Provider Name (Legal Business Name): ZAINAB A, G. AYOOLA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 05/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2833 GEORGIA AVE NW # B1
WASHINGTON DC
20001-3862
US

IV. Provider business mailing address

13040 OLD STAGE COACH RD APT 112
LAUREL MD
20708-1613
US

V. Phone/Fax

Practice location:
  • Phone: 202-588-8036
  • Fax:
Mailing address:
  • Phone: 240-646-2856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA10093
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: