Provider Demographics
NPI:1083168637
Name:USAWASDI, EVE (WHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:EVE
Middle Name:
Last Name:USAWASDI
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2802 141ST ST
Mailing Address - Street 2:APT. 5E
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-1672
Mailing Address - Country:US
Mailing Address - Phone:646-704-1086
Mailing Address - Fax:
Practice Address - Street 1:2802 141ST ST
Practice Address - Street 2:APT. 5E
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-1672
Practice Address - Country:US
Practice Address - Phone:646-704-1086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF421223363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health