Healthcare Provider Details

I. General information

NPI: 1780264465
Provider Name (Legal Business Name): RABIAT OSUNSADE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 POST OFFICE RD STE 101
WALDORF MD
20602-2738
US

IV. Provider business mailing address

600 PENNSYLVANIA AVE SE UNIT 15859
WASHINGTON DC
20003-7535
US

V. Phone/Fax

Practice location:
  • Phone: 202-431-6494
  • Fax: 202-972-6430
Mailing address:
  • Phone: 202-431-6494
  • Fax: 202-972-6430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1030157
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: