Provider Demographics
NPI:1033808126
Name:KOROMA, FATIMA BINTA
Entity Type:Individual
Prefix:
First Name:FATIMA
Middle Name:BINTA
Last Name:KOROMA
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 1:998 INVERNESS GLN
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-8475
Mailing Address - Country:US
Mailing Address - Phone:614-632-0139
Mailing Address - Fax:
Practice Address - Street 1:998 INVERNESS GLN
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-8475
Practice Address - Country:US
Practice Address - Phone:614-632-0139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health