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General NPI Number Information
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NPI Number | 1568347151
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Entity Type | Individual
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Provider Name | MARIAMA JALLOH FNP
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Gender | Female
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Dates
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Enumeration Date | 08/11/2025
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Last Update Date | 11/22/2025
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Provider Practice Location Address
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Address Line | 44 GLENWOOD AVE STE 201
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City | EAST ORANGE
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State | NJ
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Zip | 07017-1557
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Country | US
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Telephone | 973-673-6100
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Fax | 973-673-7780
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Provider Business Mailing Address
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Address Line | 61 N 7TH ST APT 2
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City | NEWARK
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State | NJ
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Zip | 07107-2954
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Country | US
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Telephone | 973-392-0127
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Fax |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 26NJ15369900
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License Number State | NJ
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