Provider Demographics
NPI:1821489493
Name:ABEBE, MEZGEBU
Entity Type:Individual
Prefix:
First Name:MEZGEBU
Middle Name:
Last Name:ABEBE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 HAWTHORNE AVE
Mailing Address - Street 2:APT 2D
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-1063
Mailing Address - Country:US
Mailing Address - Phone:914-375-4359
Mailing Address - Fax:
Practice Address - Street 1:159 HAWTHORNE AVE
Practice Address - Street 2:APT 2D
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-1063
Practice Address - Country:US
Practice Address - Phone:914-375-4359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)