Provider Demographics
NPI:1629965157
Name:URASSA, ELLYAGAPE PAUL
Entity type:Individual
Prefix:MR
First Name:ELLYAGAPE
Middle Name:PAUL
Last Name:URASSA
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:ST. BARNABAS HOSPITAL
Mailing Address - Street 2:4422 THIRD AVENUE, MILLS BUILDING, 4TH FLOOR, ROOM 406
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-2594
Mailing Address - Country:US
Mailing Address - Phone:718-960-6635
Mailing Address - Fax:718-960-9418
Practice Address - Street 1:ST. BARNABAS HOSPITAL
Practice Address - Street 2:4422 THIRD AVENUE, MILLS BUILDING, 4TH FLOOR, ROOM 406
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-2594
Practice Address - Country:US
Practice Address - Phone:718-960-6635
Practice Address - Fax:718-960-9418
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program