Provider Demographics
NPI:1043046543
Name:ASIAMAH, PHINEHAS
Entity type:Individual
Prefix:
First Name:PHINEHAS
Middle Name:
Last Name:ASIAMAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 UNIVERSAL CITY PLZ
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91608-1002
Mailing Address - Country:US
Mailing Address - Phone:312-358-4609
Mailing Address - Fax:
Practice Address - Street 1:350 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10118-0110
Practice Address - Country:US
Practice Address - Phone:312-358-4609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician