Provider Demographics
NPI:1518228048
Name:SALAU, ISMAILA
Entity Type:Individual
Prefix:
First Name:ISMAILA
Middle Name:
Last Name:SALAU
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 1:6868 RIVERDALE RD
Mailing Address - Street 2:#101
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1061
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6868 RIVERDALE RD
Practice Address - Street 2:#101
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-1061
Practice Address - Country:US
Practice Address - Phone:240-386-7518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide