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General NPI Number Information
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NPI Number | 1871724112
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Entity Type | Individual
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Provider Name | AMARA SYLLA
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Gender | Male
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Dates
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Enumeration Date | 08/04/2009
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Last Update Date | 11/23/2009
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Provider Practice Location Address
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Address Line | 4523 SUNNINGDALE AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-5750
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Country | US
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Telephone | 505-266-3915
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Fax |
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Provider Business Mailing Address
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Address Line | 12224 VICTORIA FALLS DR NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-5437
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Country | US
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Telephone | 505-261-2129
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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