MRS. BUSIME MIMY MUDEKEREZA


Address: 1885 Adam Clayton Powell Jr Blvd Apt 2c, New York, NY 10026-2892
Phone: 2127950529

MRS. BUSIME MIMY MUDEKEREZA (NPI# 1942822507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1942822507
Entity Type Individual
Full Name MRS. BUSIME MIMY MUDEKEREZA
Credential NP
Practice Address 1885 Adam Clayton Powell Jr Blvd Apt 2c
New York
NY 10026-2892
Practice Telephone 2127950529
Enumeration Date 2020-05-17
Last Update Date 2020-05-17
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
F344790-01 NY Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1885 ADAM CLAYTON POWELL JR BLVD APT 2C
City NEW YORK
State NY
Zip Code 10026-2892

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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Competitor

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City NEW YORK
Zip Code 10026

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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