Healthcare Provider Details

I. General information

NPI: 1245852003
Provider Name (Legal Business Name): ZELALEM TADESSE ARGAW FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2020
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 ELBOWOODS LP, NEW TOWN, ND 58763
NEW TOWN ND
58763
US

IV. Provider business mailing address

35 DAVENPORT AVE APT 5A
NEW ROCHELLE NY
10805-3459
US

V. Phone/Fax

Practice location:
  • Phone: 701-627-4750
  • Fax:
Mailing address:
  • Phone: 646-334-8289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number619251
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF345798
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: