Provider Demographics
NPI:1952033409
Name:BAH, MARIAMA BENTEH
Entity Type:Individual
Prefix:
First Name:MARIAMA
Middle Name:BENTEH
Last Name:BAH
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 1:70 HELMS MILL RD
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-4172
Mailing Address - Country:US
Mailing Address - Phone:347-668-7651
Mailing Address - Fax:
Practice Address - Street 1:503 OMNI DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4528
Practice Address - Country:US
Practice Address - Phone:908-595-1199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program