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NPI Code Detail

MEDICARE: TIGISTI NEGHASSI

MEDICARE: TIGISTI NEGHASSI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner358300NY

General Provider Information

NPI Number : 1053268607
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIGISTI NEGHASSI
Provider Business Mailing Address
First Line : 375 MILL HOOK RD
Second Line :
City : ACCORD
State : NY
Zip : 12404-5821
Country : US
Telephone Number : 845-332-5814
Fax Number :
Provider Business Practice Location Address
First Line : 330 POWELL AVE
Second Line :
City : NEWBURGH
State : NY
Zip : 12550-3412
Country : US
Telephone Number : 845-561-0800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2026
Last Update Date : 03/12/2026

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Directions to “ TIGISTI NEGHASSI ” Practice Location

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