Provider Demographics
NPI:1215155114
Name:OLUSEYE, ADEYANJU
Entity type:Individual
Prefix:
First Name:ADEYANJU
Middle Name:
Last Name:OLUSEYE
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 1:8554 SCORCHWOOD DRIVE
Mailing Address - Street 2:APT 3A
Mailing Address - City:SAVAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20763
Mailing Address - Country:US
Mailing Address - Phone:410-428-7943
Mailing Address - Fax:
Practice Address - Street 1:8554 SCORCHWOOD DRIVE
Practice Address - Street 2:APT 3A
Practice Address - City:SAVAGE
Practice Address - State:MD
Practice Address - Zip Code:20763
Practice Address - Country:US
Practice Address - Phone:410-428-7943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician