Healthcare Provider Details

I. General information

NPI: 1609136068
Provider Name (Legal Business Name): MRS. FEYISAYO OLADOYIN ADEFABI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2012
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 NEW YORK AVE NE 228
WASHINGTON DC
20002-1848
US

IV. Provider business mailing address

2512 24TH ST NE
WASHINGTON DC
20018-2126
US

V. Phone/Fax

Practice location:
  • Phone: 202-832-8340
  • Fax:
Mailing address:
  • Phone: 202-832-8340
  • Fax: 202-832-8341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: