Individual
KADIJATU MANSARAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 HICKORY RD, PLYMOUTH MEETING, PA 19462-1047
(800) 879-4471
Mailing address
6705 HOMESTAKE DR, BOWIE, MD 20720-3315
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R174285
MD
Other
Enumeration date
04/15/2009
Last updated
04/15/2009
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