Provider Demographics
NPI:1942903265
Name:AKABANE, ANDRESSA LUMI (MD MMSC)
Entity type:Individual
Prefix:
First Name:ANDRESSA
Middle Name:LUMI
Last Name:AKABANE
Suffix:
Gender:F
Credentials:MD MMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2138
Mailing Address - Country:US
Mailing Address - Phone:508-334-5979
Mailing Address - Fax:508-334-5232
Practice Address - Street 1:281 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2138
Practice Address - Country:US
Practice Address - Phone:508-334-5979
Practice Address - Fax:508-334-5232
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program