Provider Demographics
NPI:1245739341
Name:UKO-ABASI, EMA
Entity Type:Individual
Prefix:DR
First Name:EMA
Middle Name:
Last Name:UKO-ABASI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 DWIGHT RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1768
Mailing Address - Country:US
Mailing Address - Phone:413-824-4070
Mailing Address - Fax:
Practice Address - Street 1:171 DWIGHT RD STE 102
Practice Address - Street 2:
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106-1768
Practice Address - Country:US
Practice Address - Phone:413-824-4070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-05
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23783363LF0000X
MARN2358169363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN23783OtherSTATE LICENSE NUMBER
COC-APN.0001216-C-NPOtherSTATE LICENSE NUMBER
MARN2358169OtherSTATE LICENSE