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NPI Code Detail

MEDICARE: HERBERT ABIFOLA ISHOLA

MEDICARE: HERBERT ABIFOLA ISHOLA
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
1374U00000XHome Health AideHHA200004569DC

General Provider Information

NPI Number : 1376352179
Entity Type Code : Individual
Provider Name (Legal Business Name) : HERBERT ABIFOLA ISHOLA
Provider Business Mailing Address
First Line : 2314 BRIGHTSEAT RD APT 6
Second Line :
City : LANDOVER
State : MD
Zip : 20785-3554
Country : US
Telephone Number : 312-792-5583
Fax Number :
Provider Business Practice Location Address
First Line : 2314 BRIGHTSEAT RD APT 6
Second Line :
City : LANDOVER
State : MD
Zip : 20785-3554
Country : US
Telephone Number : 312-792-5583
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2025
Last Update Date : 01/06/2025

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Directions to “ HERBERT ABIFOLA ISHOLA ” Practice Location

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