Provider Demographics
NPI:1295218485
Name:AYEW, SAMIA TIRA (RN)
Entity Type:Individual
Prefix:MISS
First Name:SAMIA
Middle Name:TIRA
Last Name:AYEW
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1978 UNIVERSITY AVE APT 4N
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-4464
Mailing Address - Country:US
Mailing Address - Phone:347-279-0848
Mailing Address - Fax:
Practice Address - Street 1:1978 UNIVERSITY AVE APT 4N
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4464
Practice Address - Country:US
Practice Address - Phone:347-279-0848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY757281163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY757281OtherRN LICENSE VERIFICATION NUMBER