Organization Active NPI

Hadiatou Diallo'S Primary & Mental Care LLC

  • Family Medicine Physician
  • Jersey City, NJ
National Provider Identifier
1780411587
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HADIATOU DIALLO'S PRIMARY & MENTAL CARE LLC
Practice address
97 Newkirk St Apt 228-229
Jersey City, NJ 07306-3021
Phone
(201) 618-6623
NPI assigned
Sep 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ibrahima Diallo, NPNPI 1639651714
Title
Owner
Phone
(201) 618-6623

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

97 Newkirk St Apt 228-229
Jersey City, NJ 07306-3021

Mailing address

155 Willowbrook Blvd Ste 110
Wayne, NJ 07470-7033
Phone (201) 618-6623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241116000012 NJ Part B Supplier - Clinic/Group Practice 3971037680 Receives reassigned benefits from 7 practitioners
Practice locations: North Bergen, NJ; Oak Ridge, NJ; Oradell, NJ; Pennsauken, NJ; Phillipsburg, NJ; Union City, NJ; Secaucus, NJ; Montville, NJ…

National Provider Directory

National Provider Directory

Locations

14 Church St
Newton, NJ 07860
Phone (862) 362-6408

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1780411587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 WILLOWBROOK BLVD STE 110",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707033",
            "telephone_number": "201-618-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 NEWKIRK ST APT 228-229",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073063021",
            "telephone_number": "201-618-6623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HADIATOU DIALLO'S PRIMARY & MENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "DIALLO",
        "authorized_official_first_name": "IBRAHIMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-618-6623",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.