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NPI 1477862605

NPI 1477862605 : ASHANTE MONIQUE OSEI ASIBEY ATC : FORT DRUM, NY

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General NPI Number Information
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    NPI Number           |    1477862605
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    Entity Type          |    Individual 
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    Provider Name        |    ASHANTE MONIQUE OSEI ASIBEY ATC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/06/2010
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    Last Update Date     |    12/29/2025
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Provider Practice Location Address
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    Address Line         |    20460 ANACONDA ROAD 
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    City                 |    FORT DRUM
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    State                |    NY
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    Zip                  |    13603
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    Country              |    US
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    Telephone            |    315-774-1479
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    21610 COUNTY ROUTE 47 
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    City                 |    CARTHAGE
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    State                |    NY
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    Zip                  |    13619-8620
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    Country              |    US
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    Telephone            |    
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    004564-01
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    License Number State |    NY
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