1518891555 NPI number — REDIET TADESSE AMARE MD

Table of content: REDIET TADESSE AMARE MD (NPI 1518891555)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518891555 NPI number — REDIET TADESSE AMARE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AMARE
Provider First Name:
REDIET
Provider Middle Name:
TADESSE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518891555
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/12/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ST. JOSEPH CHURCH, NIFAS SILK LAFTO
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ADDIS ABABA
Provider Business Mailing Address State Name:
ADDIS ABABA
Provider Business Mailing Address Postal Code:
01000
Provider Business Mailing Address Country Code:
ET
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
760 BROADWAY BROOKLYN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK CITY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-963-8000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/12/2026

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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