Provider Demographics
NPI:1558754739
Name:ASUZU, NOSATA ASHLEY (DNP,FNP-BC,PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:NOSATA
Middle Name:ASHLEY
Last Name:ASUZU
Suffix:
Gender:F
Credentials:DNP,FNP-BC,PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 TARRYTOWN RD STE 1126
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607-1313
Mailing Address - Country:US
Mailing Address - Phone:914-809-0990
Mailing Address - Fax:
Practice Address - Street 1:104 W 40TH ST STE 416
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-3617
Practice Address - Country:US
Practice Address - Phone:212-369-6757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006932363LF0000X
NY33339400363LF0000X
NYF403321363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008070997Medicaid
NYPENDINGMedicaid