Provider Demographics
NPI:1033969043
Name:NDIAYE, MANSOUR
Entity Type:Individual
Prefix:
First Name:MANSOUR
Middle Name:
Last Name:NDIAYE
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 1:625 CHESAPEAKE ST SE APT 208B
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3635
Mailing Address - Country:US
Mailing Address - Phone:202-270-8653
Mailing Address - Fax:
Practice Address - Street 1:60 HAWAII AVE NE APT 106
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-4937
Practice Address - Country:US
Practice Address - Phone:202-390-8773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant