Provider Demographics
NPI:1053003285
Name:AYANLAJA, OLUWASEYI
Entity type:Individual
Prefix:
First Name:OLUWASEYI
Middle Name:
Last Name:AYANLAJA
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 1:13204 MILES CT APT 402
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-2031
Mailing Address - Country:US
Mailing Address - Phone:443-453-2923
Mailing Address - Fax:
Practice Address - Street 1:13204 MILES CT APT 402
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-2031
Practice Address - Country:US
Practice Address - Phone:443-453-2923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
DCHHA200002860374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No171M00000XOther Service ProvidersCase Manager/Care Coordinator