Individual
MOUSSA DIALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3663 HARPER AVE PH, BRONX, NY 10466-5906
(646) 377-6786
Mailing address
3663 HARPER AVE PH, BRONX, NY 10466-5906
(646) 377-6786
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
312861
NY
Other
Enumeration date
05/22/2013
Last updated
05/22/2013
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