Provider Demographics
NPI:1023796364
Name:DIAGNE, MAME DIARRA
Entity type:Individual
Prefix:
First Name:MAME
Middle Name:DIARRA
Last Name:DIAGNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 E 102ND ST APT 6D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-5822
Mailing Address - Country:US
Mailing Address - Phone:929-497-2566
Mailing Address - Fax:
Practice Address - Street 1:431 E 102ND ST APT 6D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-5822
Practice Address - Country:US
Practice Address - Phone:929-497-2566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health