Provider Demographics
NPI:1518262781
Name:HUSSEIN, ASHA M
Entity Type:Individual
Prefix:
First Name:ASHA
Middle Name:M
Last Name:HUSSEIN
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 1:4937 WEST BROAD STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228
Mailing Address - Country:US
Mailing Address - Phone:614-439-0007
Mailing Address - Fax:614-515-5913
Practice Address - Street 1:4937 W BROAD ST
Practice Address - Street 2:SUITE 101
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-1646
Practice Address - Country:US
Practice Address - Phone:614-439-0007
Practice Address - Fax:614-515-5913
Is Sole Proprietor?:No
Enumeration Date:2011-01-20
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide