Provider Demographics
NPI:1639927353
Name:USMAN, AYESHA (MBBS)
Entity type:Individual
Prefix:
First Name:AYESHA
Middle Name:
Last Name:USMAN
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 MISTY POND CIRCLE
Mailing Address - Street 2:APT 11
Mailing Address - City:MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11955
Mailing Address - Country:US
Mailing Address - Phone:631-526-2315
Mailing Address - Fax:
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-4321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program