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General NPI Number Information
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NPI Number | 1326258385
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Entity Type | Individual
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Provider Name | IBRAHIMA DIALLO PT
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 7309 HANOVER PKWY STE A
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City | GREENBELT
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State | MD
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Zip | 20770-3666
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Country | US
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Telephone | 301-446-1724
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Fax | 301-446-1726
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Provider Business Mailing Address
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Address Line | 8843 GREENBELT RD # 347
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City | GREENBELT
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State | MD
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Zip | 20770-2451
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Country | US
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Telephone | 301-446-1724
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Fax | 301-446-1726
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 870275
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 19812
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License Number State | MD
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