Provider Demographics
NPI:1700670171
Name:MANKAA, DIANA NIBA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:NIBA
Last Name:MANKAA
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 1:10010 MARTIN AVE
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9209
Mailing Address - Country:US
Mailing Address - Phone:240-425-5664
Mailing Address - Fax:
Practice Address - Street 1:10010 MARTIN AVE
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9209
Practice Address - Country:US
Practice Address - Phone:240-425-5664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator