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Individual

ASSA FISIRU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1368 WEBSTER AVE APT 13K, BRONX, NY 10456-1838
(929) 240-6221
Mailing address
1368 WEBSTER AVE APT 13K, BRONX, NY 10456-1838
(929) 240-6221

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
630326930
ESSENTIAL HEALTH PLAN 1
NY
Enumeration date
06/23/2020
Last updated
06/23/2020
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