Provider Demographics
NPI:1295072890
Name:FAMINU, OLAYEMI J
Entity type:Individual
Prefix:
First Name:OLAYEMI
Middle Name:J
Last Name:FAMINU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6335 LANDOVER RD APT 202
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1335
Mailing Address - Country:US
Mailing Address - Phone:240-487-8132
Mailing Address - Fax:
Practice Address - Street 1:6335 LANDOVER RD APT 202
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1335
Practice Address - Country:US
Practice Address - Phone:240-487-8132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide