Provider Demographics
NPI:1437966249
Name:OSUNNIYI, TAJUDEEN A
Entity type:Individual
Prefix:
First Name:TAJUDEEN
Middle Name:A
Last Name:OSUNNIYI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8033 WOODGATE CT APT C
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-3767
Mailing Address - Country:US
Mailing Address - Phone:240-467-9214
Mailing Address - Fax:
Practice Address - Street 1:8033 WOODGATE CT APT C
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-3767
Practice Address - Country:US
Practice Address - Phone:240-467-9214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide