Provider Demographics
NPI:1558195420
Name:ABSIYA, BUH A
Entity type:Individual
Prefix:
First Name:BUH
Middle Name:A
Last Name:ABSIYA
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 1:200 WILKIN ST APT 210
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-4430
Mailing Address - Country:US
Mailing Address - Phone:651-500-6439
Mailing Address - Fax:
Practice Address - Street 1:200 WILKIN ST APT 210
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-4430
Practice Address - Country:US
Practice Address - Phone:651-500-6439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-31
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker