Provider Demographics
NPI:1659085546
Name:SOUMARE, FATIMAH BINTOU
Entity Type:Individual
Prefix:
First Name:FATIMAH
Middle Name:BINTOU
Last Name:SOUMARE
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 1:2557 MUSTANG DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-3741
Mailing Address - Country:US
Mailing Address - Phone:646-808-9132
Mailing Address - Fax:
Practice Address - Street 1:2557 MUSTANG DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-3741
Practice Address - Country:US
Practice Address - Phone:646-808-9132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker