Healthcare Provider Details

I. General information

NPI: 1073247235
Provider Name (Legal Business Name): GEORGINA DAAKYIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 07/13/2022
Certification Date: 07/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 MCCLELLAN ST
BRONX NY
10456-4810
US

IV. Provider business mailing address

185 MCCLELLAN ST
BRONX NY
10456-4810
US

V. Phone/Fax

Practice location:
  • Phone: 347-324-7630
  • Fax:
Mailing address:
  • Phone: 347-324-7630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number842757
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: