Provider Demographics
NPI:1033823323
Name:JEAN, KHADY DIATOU
Entity Type:Individual
Prefix:
First Name:KHADY
Middle Name:DIATOU
Last Name:JEAN
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 1:303 BROMLEY DR
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-1819
Mailing Address - Country:US
Mailing Address - Phone:908-265-1699
Mailing Address - Fax:
Practice Address - Street 1:303 BROMLEY DR
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-1819
Practice Address - Country:US
Practice Address - Phone:908-265-1699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula