Provider Demographics
NPI:1073943361
Name:ASANTE, GRACE OBIRIBEA
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:OBIRIBEA
Last Name:ASANTE
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 1:102 WINDING BROOK CT
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-8370
Mailing Address - Country:US
Mailing Address - Phone:914-439-6072
Mailing Address - Fax:
Practice Address - Street 1:102 WINDING BROOK CT
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-8370
Practice Address - Country:US
Practice Address - Phone:914-439-6072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002038176B00000X
NY676157163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse