Provider Demographics
NPI:1932583929
Name:KAKAY-DIALLO, ISATU (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ISATU
Middle Name:
Last Name:KAKAY-DIALLO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1400 PELHAM PKWY S
Mailing Address - Street 2:BUILDING # 1, 4 NORTH SUITE B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1138
Mailing Address - Country:US
Mailing Address - Phone:718-918-5747
Mailing Address - Fax:718-918-7035
Practice Address - Street 1:1400 PELHAM PKWY S
Practice Address - Street 2:BUILDING # 1, 4 NORTH SUITE B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1138
Practice Address - Country:US
Practice Address - Phone:718-918-5747
Practice Address - Fax:718-918-7035
Is Sole Proprietor?:No
Enumeration Date:2015-07-20
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF-339382363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400127031Medicare PIN