Provider Demographics
NPI:1982224580
Name:JALLOH, RUGIATU
Entity Type:Individual
Prefix:
First Name:RUGIATU
Middle Name:
Last Name:JALLOH
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 1:1464 4TH ST SW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-2204
Mailing Address - Country:US
Mailing Address - Phone:202-717-0505
Mailing Address - Fax:
Practice Address - Street 1:900 G ST NE APT 802
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-7406
Practice Address - Country:US
Practice Address - Phone:202-367-1572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant