Provider Demographics
NPI:1396009585
Name:SYLLA, HAMADOU
Entity Type:Individual
Prefix:MR
First Name:HAMADOU
Middle Name:
Last Name:SYLLA
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 1:711 HUDSON AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6864
Mailing Address - Country:US
Mailing Address - Phone:770-722-5356
Mailing Address - Fax:
Practice Address - Street 1:711 HUDSON AVE APT 7
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6864
Practice Address - Country:US
Practice Address - Phone:770-722-5356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide