Provider Demographics
NPI:1164397493
Name:DIAGNE, AISSA
Entity type:Individual
Prefix:
First Name:AISSA
Middle Name:
Last Name:DIAGNE
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 1:600 FAIRVIEW AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5954
Mailing Address - Country:US
Mailing Address - Phone:301-257-4023
Mailing Address - Fax:
Practice Address - Street 1:5272 RIVER RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-1405
Practice Address - Country:US
Practice Address - Phone:301-257-4023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200001268374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide