Individual
MR. IDRISSA CISSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
493 VALLEY STREET, APT 8, ORANGE, NJ 07050
(301) 283-1954
Mailing address
493 VALLEY STREET, APT 8, ORANGE, NJ 07050
(301) 283-1954
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
2019-1474
NJ
Other
Enumeration date
05/21/2019
Last updated
05/21/2019
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