NPI 1245482413 · live from the CMS NPI Registry
Fayrose Fouad Abodeshisha, RPA-C
Physician Assistant, Surgical in New York, NY. National Provider Identifier 1245482413, active.
NPI record
| NPI | 1245482413 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Surgical 363AS0400X |
| Practice location | 462 1st Ave, New York, NY 10016 |
| Practice phone | 212-562-3917 |
| Mailing address | 331 Newman Springs Road, Bldg. 2, Suite 220, Red Bank, NJ 07701 |
| Enumerated | October 18, 2008 |
| Last updated | January 6, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Surgical primary | 363AS0400X | 23 012911 (NY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.