Provider Demographics
NPI:1326308826
Name:JALLOH, ISATU
Entity Type:Individual
Prefix:
First Name:ISATU
Middle Name:
Last Name:JALLOH
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 1:50 HAWAII AVE NE
Mailing Address - Street 2:APT 211
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-4980
Mailing Address - Country:US
Mailing Address - Phone:202-361-3899
Mailing Address - Fax:
Practice Address - Street 1:50 HAWAII AVE NE
Practice Address - Street 2:APT 211
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-4980
Practice Address - Country:US
Practice Address - Phone:202-361-3899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC2067717374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide