MEDICARE: MR. ABDALLAHI DIOP RN

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	163W00000X	Registered Nurse	556536	NY

General Provider Information

NPI Number	:	1740480664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ABDALLAHI DIOP RN

Provider Business Mailing Address
First Line	:	755 FENIMORE ST
Second Line	:	APT 2F
City	:	BROOKLYN
State	:	NY
Zip	:	11203-1870
Country	:	US
Telephone Number	:	201-993-2818
Fax Number	:	347-789-6112

Provider Business Practice Location Address
First Line	:	755 FENIMORE ST
Second Line	:	APT 2F
City	:	BROOKLYN
State	:	NY
Zip	:	11203-1870
Country	:	US
Telephone Number	:	201-993-2818
Fax Number	:	347-789-6112

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

Provider Enumeration Date	:	07/19/2007
Last Update Date	:	07/19/2007

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