Provider Demographics
NPI:1689065492
Name:ASMAH, ABEGAIL M
Entity Type:Individual
Prefix:
First Name:ABEGAIL
Middle Name:M
Last Name:ASMAH
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 1:491 EAST 162ND STREET.
Mailing Address - Street 2:7E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451
Mailing Address - Country:US
Mailing Address - Phone:347-653-3505
Mailing Address - Fax:
Practice Address - Street 1:491 E 162 ST APT 7E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-4266
Practice Address - Country:US
Practice Address - Phone:347-653-3505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY695382163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY695382Other695382