1497095004 NPI number — MRS. MOTUNDE GBEMINIYI ALADE CSW

Table of content: MRS. MOTUNDE GBEMINIYI ALADE CSW (NPI 1497095004)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497095004 NPI number — MRS. MOTUNDE GBEMINIYI ALADE CSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALADE
Provider First Name:
MOTUNDE
Provider Middle Name:
GBEMINIYI
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OGOH
Provider Other First Name:
MOTUNDE
Provider Other Middle Name:
G
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
HHA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1497095004
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17 SUGARBERRY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELKTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21921-4845
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-257-1620
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17 SUGARBERRY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELKTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21921-4845
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-257-1620
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/19/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 374U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171M00000X , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 171M00000X , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".




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