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General NPI Number Information
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NPI Number | 1689387920
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Entity Type | Individual
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Provider Name | EUGENE ASONYE
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Gender | Male
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Dates
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Enumeration Date | 01/02/2023
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Last Update Date | 01/02/2023
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Provider Practice Location Address
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Address Line | 146 TUDOR DR
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City | NORTH WALES
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State | PA
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Zip | 19454-1626
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Country | US
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Telephone | 267-471-2972
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Fax | 215-646-3124
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Provider Business Mailing Address
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Address Line | 146 TUDOR DR
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City | NORTH WALES
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State | PA
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Zip | 19454-1626
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Country | US
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Telephone | 267-471-2972
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Fax | 215-646-3124
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BH000269
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License Number State | PA
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