Provider Demographics
NPI:1255051306
Name:ALEMU, FITSUM ESHETU (PMHNP)
Entity type:Individual
Prefix:
First Name:FITSUM
Middle Name:ESHETU
Last Name:ALEMU
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:FITSUM
Other - Middle Name:ESHETU
Other - Last Name:ALEMU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP
Mailing Address - Street 1:7 TENNEY RD
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1315
Mailing Address - Country:US
Mailing Address - Phone:973-518-2517
Mailing Address - Fax:
Practice Address - Street 1:7 TENNEY RD
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1315
Practice Address - Country:US
Practice Address - Phone:973-518-2517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01319300363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health