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NPI Code Detail

MEDICARE: IDRISS DJOMO

MEDICARE:   IDRISS  DJOMO
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
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1841558889
Entity Type Code : Individual
Provider Name (Legal Business Name) : IDRISS DJOMO
Provider Business Mailing Address
First Line : 7600 MAPLE AVE
Second Line : APT 310
City : TAKOMA PARK
State : MD
Zip : 20912-5571
Country : US
Telephone Number : 202-569-9854
Fax Number :
Provider Business Practice Location Address
First Line : 7600 MAPLE AVE
Second Line : APT 310
City : TAKOMA PARK
State : MD
Zip : 20912-5571
Country : US
Telephone Number : 202-569-9854
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2012
Last Update Date : 04/27/2012

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Directions to “ IDRISS DJOMO ” Practice Location

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