Provider Demographics
NPI:1811745201
Name:ALEMU, ERMIYAS WELDESEMAYAT (MD)
Entity type:Individual
Prefix:MR
First Name:ERMIYAS
Middle Name:WELDESEMAYAT
Last Name:ALEMU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 KNOX PLACE 4H
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467
Mailing Address - Country:US
Mailing Address - Phone:929-768-2251
Mailing Address - Fax:718-579-4836
Practice Address - Street 1:234 E. 149TH STREET
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451
Practice Address - Country:US
Practice Address - Phone:718-579-5000
Practice Address - Fax:718-579-4836
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2025-02-04
Deactivation Date:2025-01-10
Deactivation Code:
Reactivation Date:2025-02-04
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program