Provider Demographics
NPI:1659604288
Name:ASANTE-FACEY, AL (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MR
First Name:AL
Middle Name:
Last Name:ASANTE-FACEY
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:ELIZABETH
Other - Last Name:ASANTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:65 PARK TERRACE WEST
Mailing Address - Street 2:APT 3B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034
Mailing Address - Country:US
Mailing Address - Phone:646-923-5295
Mailing Address - Fax:212-434-3775
Practice Address - Street 1:111 E 57TH ST 3RD FLOOR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2009
Practice Address - Country:US
Practice Address - Phone:212-434-3770
Practice Address - Fax:212-434-3775
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013550363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical