Provider Demographics
NPI:1073822193
Name:JALLOH, CHERNOR (RN)
Entity Type:Individual
Prefix:
First Name:CHERNOR
Middle Name:
Last Name:JALLOH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2778 SCHLEY AVE
Mailing Address - Street 2:APT-3A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-2755
Mailing Address - Country:US
Mailing Address - Phone:718-671-2100
Mailing Address - Fax:
Practice Address - Street 1:2778 SCHLEY AVE
Practice Address - Street 2:APT-3A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2755
Practice Address - Country:US
Practice Address - Phone:718-671-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY633660163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse