Provider Demographics
NPI:1083476220
Name:ABDULKADIR, ASMA
Entity Type:Individual
Prefix:
First Name:ASMA
Middle Name:
Last Name:ABDULKADIR
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 1:499 S WARREN ST STE 707
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-2615
Mailing Address - Country:US
Mailing Address - Phone:315-316-4160
Mailing Address - Fax:
Practice Address - Street 1:499 S WARREN ST STE 707
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-2615
Practice Address - Country:US
Practice Address - Phone:315-316-4160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY369744795172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver