NPIMap

Idrissa Cisse

Individual provider Active NPI Non-emergency Medical Transport (VAN) · Orange, NJ

NPI 1013574516 · NPPES record last updated May 21, 2019

Key facts

NPI
1013574516
Entity type
Individual (NPI type 1)
Primary specialty
Non-emergency Medical Transport (VAN) 343900000X
License
2019-1474 (NJ)
Practice address
493 Valley Street
Apt 8
Orange, NJ 07050
Phone
(301) 283-1954
NPI assigned
May 21, 2019
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2019-1474NJMDNon-emergency Medical Transport (VAN)

Practice roles

OrganizationSpecialtyStatusNew patients
Oumou Transportation Services LLC Non-Emergency Medical Transport (Van) Past
since Mar 22, 2020		 Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 2019-1474 NJ Yes

Addresses

Primary practice location

493 Valley Street
Apt 8
Orange, NJ 07050

Mailing address

493 Valley Street
Apt 8
Orange, NJ 07050
Phone (301) 283-1954

Other providers in Orange, NJ

All providers in Orange, NJ · Non-emergency Medical Transport (VAN) in New Jersey

Sources for this page

Verify at the official NPI Registry.