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NPI Code Detail

MEDICARE: KEHINDE TIJANI

MEDICARE: KEHINDE TIJANI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0019XPhysical Rehabilitation Occupational Therapist07779MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NAOTHERNA

General Provider Information

NPI Number : 1194206102
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEHINDE TIJANI
Provider Business Mailing Address
First Line : 152 SPECTATOR LN
Second Line :
City : OWINGS MILLS
State : MD
Zip : 21117-4444
Country : US
Telephone Number : 410-940-1983
Fax Number :
Provider Business Practice Location Address
First Line : 12020 REISTERSTOWN RD
Second Line :
City : REISTERSTOWN
State : MD
Zip : 21136-3041
Country : US
Telephone Number : 410-833-3801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2018
Last Update Date : 02/26/2020

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