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General NPI Number Information
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NPI Number | 1154909000
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Entity Type | Individual
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Provider Name | NATNAELLE ERMYAS ADMASSU MD, MS
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Gender | Male
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Dates
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Enumeration Date | 03/31/2021
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 262 W 53RD ST FL 1
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City | NEW YORK
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State | NY
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Zip | 10019-5807
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Country | US
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Telephone | 212-641-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 262 W 53RD ST FL 1
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City | NEW YORK
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State | NY
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Zip | 10019-5807
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Country | US
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Telephone | 212-641-4500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 339838
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License Number State | NY
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