MEDICARE: SAKHO ABOUBAKARY I

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker
2	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1326939851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAKHO ABOUBAKARY I

Provider Business Mailing Address
First Line	:	2028 GRAND CONCOURSE APT 5A
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10457-3945
Country	:	US
Telephone Number	:	347-536-9251
Fax Number	:

Provider Business Practice Location Address
First Line	:	2028 GRAND CONCOURSE APT 5A
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10457-3945
Country	:	US
Telephone Number	:	347-536-9251
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2025
Last Update Date	:	07/12/2025

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