Provider Demographics
NPI:1386230647
Name:ASHANTI WARRIOR INTERNATIONAL INC.
Entity Type:Organization
Organization Name:ASHANTI WARRIOR INTERNATIONAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MONIFA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAAT
Authorized Official - Suffix:
Authorized Official - Credentials:CPT, CHA
Authorized Official - Phone:917-497-7596
Mailing Address - Street 1:ASHANTI WARRIOR INT.
Mailing Address - Street 2:503 ROGERS AVENUE
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-5447
Mailing Address - Country:US
Mailing Address - Phone:646-232-4545
Mailing Address - Fax:
Practice Address - Street 1:322 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-3272
Practice Address - Country:US
Practice Address - Phone:646-232-4545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports DieteticsGroup - Single Specialty