Provider Demographics
NPI:1760758429
Name:NDIAYE, ALIOUNE
Entity Type:Individual
Prefix:
First Name:ALIOUNE
Middle Name:
Last Name:NDIAYE
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 1:50456 BAY RUN N
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-4684
Mailing Address - Country:US
Mailing Address - Phone:248-525-8519
Mailing Address - Fax:
Practice Address - Street 1:50456 BAY RUN N
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-4684
Practice Address - Country:US
Practice Address - Phone:248-525-8519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MID72735343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)