Basic Information
| Provider Information | |||||||||
| NPI: | 1831711894 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADU SARHENE | ||||||||
| FirstName: | PORTIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2287 JOHNSON AVE APT 8E | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104636412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2014177676 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1215 LEE ST | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229083725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4349249055 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2020 | ||||||||
| LastUpdateDate: | 08/21/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC0200X | 702004 | NY | N | Nursing Service Providers | Registered Nurse | Critical Care Medicine | 363LG0600X | 431712 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 363LA2100X | 431712 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.