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General NPI Number Information
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NPI Number | 1568819043
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Entity Type | Individual
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Provider Name | HADJA IDIATOU DIALLO CNM
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Gender | Female
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Dates
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Enumeration Date | 05/16/2016
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Last Update Date | 07/26/2022
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Provider Practice Location Address
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Address Line | 800 WALNUT ST 14TH FLR
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5109
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Country | US
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Telephone | 215-829-8000
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Fax | 215-829-8623
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Provider Business Mailing Address
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Address Line | 800 WALNUT ST 14TH FLR
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5109
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Country | US
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Telephone | 215-829-8000
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Fax | 215-829-8623
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | LK-0000182
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | MW010641
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License Number State | PA
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