Individual
MRS. DJENABOU BAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
391 E 149TH ST RM 417, BRONX, NY 10455-3907
(646) 702-6965
Mailing address
2024 BENEDICT AVE APT 4D, BRONX, NY 10462-4427
(646) 217-8492
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
K5Q8B9A
NY
374U00000X
Home Health Aide
Primary
9190L001
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PU90872W
—
NY
Enumeration date
09/14/2018
Last updated
09/14/2018
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