Provider Demographics
NPI:1043676935
Name:ANGELA DJOUMBAYE
Entity Type:Organization
Organization Name:ANGELA DJOUMBAYE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMSW
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DJOUMBAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-373-7689
Mailing Address - Street 1:1226 SOUTHERN BLVD
Mailing Address - Street 2:4F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459-3255
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1301 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3119
Practice Address - Country:US
Practice Address - Phone:212-426-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091046251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health