MEDICARE: AFRAH SALEH ABISSE

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1568007714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AFRAH SALEH ABISSE

Provider Business Mailing Address
First Line	:	1825 EASTCHESTER RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-2301
Country	:	US
Telephone Number	:	718-904-2400
Fax Number	:

Provider Business Practice Location Address
First Line	:	715 VAN NEST AVE APT 2D
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462
Country	:	US
Telephone Number	:	917-379-2346
Fax Number	:

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

Provider Enumeration Date	:	11/12/2019
Last Update Date	:	07/10/2023

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Directions to “ AFRAH SALEH ABISSE ” Practice Location

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