Provider Demographics
NPI:1336455526
Name:KARIM, AYESHA ANWARUL
Entity Type:Individual
Prefix:MRS
First Name:AYESHA
Middle Name:ANWARUL
Last Name:KARIM
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 1:1500 WATERS PL
Mailing Address - Street 2:GINSBURG OUT-PATIENT CLINIC,
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2723
Mailing Address - Country:US
Mailing Address - Phone:718-862-4568
Mailing Address - Fax:718-861-4862
Practice Address - Street 1:1500 WATERS PL
Practice Address - Street 2:GINSBURG OUT-PATIENT CLINIC,
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2723
Practice Address - Country:US
Practice Address - Phone:718-862-4568
Practice Address - Fax:718-861-4862
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO210871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical