MEDICARE: ASMAA BOUSSERHANE

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
1	282NC2000X	Children's Hospital
2	207R00000X	Internal Medicine Physician	289790	NY

General Provider Information

NPI Number	:	1427467240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASMAA BOUSSERHANE

Provider Business Mailing Address
First Line	:	1825 EASTCHESTER RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-2301
Country	:	US
Telephone Number	:	718-907-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	234 E 149TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-5504
Country	:	US
Telephone Number	:	718-579-5874
Fax Number	:	718-579-4836

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2014
Last Update Date	:	10/15/2018

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Directions to “ ASMAA BOUSSERHANE ” Practice Location

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