Samuel Olusoji Ekundayo, HHA
Individual provider Active NPI Home Health Aide · Adelphi, MD
NPI 1669717609 · NPPES record last updated Dec 3, 2012
Key facts
- NPI
- 1669717609
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Aide 374U00000X
- Practice address
- 1824 Metzerott Rd Apt A6
Adelphi, MD 20783-3403 - Phone
- (202) 545-0935
- Fax
- (202) 545-0176
- NPI assigned
- Dec 3, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Yes |
Addresses
Primary practice location
1824 Metzerott Rd Apt A6
Adelphi, MD 20783-3403
Mailing address
1824 Metzerott Rd Apt A6
Adelphi, MD 20783-3403
Phone (202) 545-0935
Other providers in Adelphi, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.