Provider Demographics
NPI:1417744475
Name:JALLOH, AMADU
Entity type:Individual
Prefix:
First Name:AMADU
Middle Name:
Last Name:JALLOH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9929 GREENBELT RD APT 302
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2221
Mailing Address - Country:US
Mailing Address - Phone:917-215-8714
Mailing Address - Fax:
Practice Address - Street 1:9929 GREENBELT RD APT 302
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2221
Practice Address - Country:US
Practice Address - Phone:917-215-8714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide