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General NPI Number Information
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NPI Number | 1952955536
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Entity Type | Individual
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Provider Name | ABOSEDE BABATUNDE
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Gender | Female
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Dates
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Enumeration Date | 07/31/2019
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Last Update Date | 07/31/2019
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Provider Practice Location Address
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Address Line | 3231 SUPERIOR LN STE A6
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City | BOWIE
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State | MD
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Zip | 20715-1939
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Country | US
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Telephone | 301-675-0078
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Fax |
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Provider Business Mailing Address
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Address Line | 12627 HILLMEADE STATION DR
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City | BOWIE
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State | MD
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Zip | 20720-3312
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Country | US
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Telephone | 301-675-0078
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | R3732
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License Number State | MD
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