MEDICARE: AINA FALADE

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
1	164W00000X	Licensed Practical Nurse	LPN1002610	DC

General Provider Information

NPI Number	:	1215304001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AINA FALADE

Provider Business Mailing Address
First Line	:	1321 MONTELLO AVE NE
Second Line	:	NORTH-EAST
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3819
Country	:	US
Telephone Number	:	202-455-1747
Fax Number	:

Provider Business Practice Location Address
First Line	:	1321 MONTELLO AVE NE
Second Line	:	NORTH-EAST
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3819
Country	:	US
Telephone Number	:	202-455-1747
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2015
Last Update Date	:	08/27/2015

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