Healthcare Provider Details
I. General information
NPI: 1679100689
Provider Name (Legal Business Name): KWAKU OPARE-SEM
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/27/2020
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20 HOSPITAL DR STE 9
TOMS RIVER NJ
08755-6434
US
IV. Provider business mailing address
20 HOSPITAL DR STE 9
TOMS RIVER NJ
08755-6434
US
V. Phone/Fax
- Phone: 732-341-1380
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | 25MA12759300 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | 25MA12759300 |
| License Number State | NJ |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | 25MA12759300 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: