MEDICARE: BUH A ABSIYA

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	376J00000X	Homemaker		MN

General Provider Information

NPI Number	:	1558195420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BUH A ABSIYA

Provider Business Mailing Address
First Line	:	200 WILKIN ST APT 210
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55102-4430
Country	:	US
Telephone Number	:	651-500-6439
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 WILKIN ST APT 210
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55102-4430
Country	:	US
Telephone Number	:	651-500-6439
Fax Number	:

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

Provider Enumeration Date	:	08/31/2024
Last Update Date	:	08/31/2024

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Directions to “ BUH A ABSIYA ” Practice Location

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