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NPI Code Detail

MEDICARE: MRS. OLABISI AGATHA DARAMY MS. LD. CNS

MEDICARE:  MRS. OLABISI AGATHA DARAMY  MS. LD. CNS
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
1133NN1002XNutrition Education NutritionistD01243MD
2133NN1002XNutrition Education NutritionistD183DC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZX1OAOTHERMDCAREFIRST BCBS
23927-0001OTHERDCCAREFIRST BCBS

General Provider Information

NPI Number : 1619193810
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. OLABISI AGATHA DARAMY MS. LD. CNS
Provider Business Mailing Address
First Line : 6475 NEW HAMPSHIRE AVE
Second Line : SUITE 504M
City : HYATTSVILLE
State : MD
Zip : 20783-3269
Country : US
Telephone Number : 301-891-4998
Fax Number : 301-879-2074
Provider Business Practice Location Address
First Line : 6475 NEW HAMPSHIRE AVE
Second Line : SUITE 504M
City : HYATTSVILLE
State : MD
Zip : 20783-3269
Country : US
Telephone Number : 301-891-4998
Fax Number : 301-879-2074
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2007
Last Update Date : 07/08/2007

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