Provider Demographics
NPI:1497552186
Name:BALDE, MAMADOU MALAL
Entity type:Individual
Prefix:MR
First Name:MAMADOU
Middle Name:MALAL
Last Name:BALDE
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 1:151 S BISHOP AVE APT M216
Mailing Address - Street 2:
Mailing Address - City:SECANE
Mailing Address - State:PA
Mailing Address - Zip Code:19018-1953
Mailing Address - Country:US
Mailing Address - Phone:484-949-0090
Mailing Address - Fax:
Practice Address - Street 1:151 S BISHOP AVE APT M216
Practice Address - Street 2:
Practice Address - City:SECANE
Practice Address - State:PA
Practice Address - Zip Code:19018-1953
Practice Address - Country:US
Practice Address - Phone:484-949-0090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator