Provider Demographics
NPI:1154793537
Name:ASHU, CECILIA
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:ASHU
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:AYUK CECILIA
Other - Middle Name:AYUK
Other - Last Name:ASHU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:M
Mailing Address - Street 1:1040 MAIN ST APT 11
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-1431
Mailing Address - Country:US
Mailing Address - Phone:781-480-4764
Mailing Address - Fax:
Practice Address - Street 1:780 AMERICAN LEGION HWY
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-3908
Practice Address - Country:US
Practice Address - Phone:618-469-8527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program