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General NPI Number Information
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NPI Number | 1982391629
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Entity Type | Individual
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Provider Name | SEFIATU ABU PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/21/2023
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 110 W PIER WAY # A
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-4617
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Country | US
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Telephone | 908-906-0931
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Fax |
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Provider Business Mailing Address
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Address Line | 223 MEDICAL CENTER DR
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City | RIVERDALE
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State | GA
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Zip | 30274-2640
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Country | US
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Telephone | 770-991-8500
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | RN253363
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License Number State | GA
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