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1306549357
ISHMAIL SIDDRA MANSARAY
WASHINGTON, DC
NPI
1306549357
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
251S00000X Community/Behavioral Health
Enumeration Date
2023-03-27
Last Update Date
2023-07-27
Business Address
ISHMAIL SIDDRA MANSARAY
2811 PENNSYLVANIA AVE SE
WASHINGTON, DC 20020-3865
Phone number: 202-894-6811
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Mailing Address
ISHMAIL SIDDRA MANSARAY
2807 WINTERBOURNE DR
UPPER MARLBORO, MD 20774-9100
Phone number: 240-606-3519
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