Healthcare Provider Details

I. General information

NPI: 1235850793
Provider Name (Legal Business Name): ALMAMY AGUIBOU BAH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2022
Last Update Date: 09/02/2022
Certification Date: 09/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 THAYER AVE
SILVER SPRING MD
20910-4508
US

IV. Provider business mailing address

5917 CHERRYWOOD TER APT 104
GREENBELT MD
20770-4271
US

V. Phone/Fax

Practice location:
  • Phone: 301-755-6107
  • Fax:
Mailing address:
  • Phone: 301-254-1696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: