Healthcare Provider Details

I. General information

NPI: 1598326795
Provider Name (Legal Business Name): MAME SAYE CISSE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2019
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 CHEW ST STE 101
ALLENTOWN PA
18102-3434
US

IV. Provider business mailing address

450 CHEW ST STE 101
ALLENTOWN PA
18102-3434
US

V. Phone/Fax

Practice location:
  • Phone: 610-776-4888
  • Fax: 833-690-3863
Mailing address:
  • Phone: 610-776-4888
  • Fax: 833-690-3863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT219011
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD478644
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: