Provider Demographics
NPI:1255164414
Name:SEIBUREH, KADIATU (RN)
Entity type:Individual
Prefix:
First Name:KADIATU
Middle Name:
Last Name:SEIBUREH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 BELMONT AVE APT 402
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-2048
Mailing Address - Country:US
Mailing Address - Phone:201-660-0317
Mailing Address - Fax:
Practice Address - Street 1:154 BELMONT AVE APT 402
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-2048
Practice Address - Country:US
Practice Address - Phone:862-405-9639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide