Healthcare Provider Details

I. General information

NPI: 1912815853
Provider Name (Legal Business Name): MAAME OBENEWAA FREMPONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1276 FRONT ST
BINGHAMTON NY
13901-1011
US

IV. Provider business mailing address

59 LESTER AVE APT 467
JOHNSON CITY NY
13790-2416
US

V. Phone/Fax

Practice location:
  • Phone: 607-722-0354
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number074373
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: