Provider Demographics
NPI:1952882987
Name:UGBIT, MUSSIE T
Entity Type:Individual
Prefix:
First Name:MUSSIE
Middle Name:T
Last Name:UGBIT
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 1:80 VAN CORTLANDT PARK S APT 23F
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3046
Mailing Address - Country:US
Mailing Address - Phone:347-364-4669
Mailing Address - Fax:
Practice Address - Street 1:80 VAN CORTLANDT PARK S
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3039
Practice Address - Country:US
Practice Address - Phone:347-364-4669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist