Provider Demographics
NPI:1417357799
Name:ANBESE, HENOKE ADMASSU
Entity Type:Individual
Prefix:
First Name:HENOKE
Middle Name:ADMASSU
Last Name:ANBESE
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 1:1416 STRIEBEL RD
Mailing Address - Street 2:106
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-2369
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1416 STRIEBEL RD
Practice Address - Street 2:106
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-2369
Practice Address - Country:US
Practice Address - Phone:614-607-9278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-24
Last Update Date:2014-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker