Provider Demographics
NPI:1790091221
Name:ABDOUL-KARIM, BASIRATU LARMIE (ANP)
Entity Type:Individual
Prefix:
First Name:BASIRATU
Middle Name:LARMIE
Last Name:ABDOUL-KARIM
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BEECH RD
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1203
Mailing Address - Country:US
Mailing Address - Phone:917-836-6452
Mailing Address - Fax:
Practice Address - Street 1:9 BEECH RD
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1203
Practice Address - Country:US
Practice Address - Phone:917-836-6452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-22
Last Update Date:2010-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305175363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health