Healthcare Provider Details

I. General information

NPI: 1932903671
Provider Name (Legal Business Name): AMBER ACQUAYE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 FENWOOD RD
BOSTON MA
02115-6128
US

IV. Provider business mailing address

703 WHITNEY AVE UNIT 14
NEW HAVEN CT
06511-1377
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-6753
  • Fax:
Mailing address:
  • Phone: 618-310-5666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number3019126
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: