Individual
ANITA MARIE MUTAWASSIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
(718) 589-2440
Mailing address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
033624
NY
Other
Enumeration date
03/03/2025
Last updated
04/03/2025
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