Healthcare Provider Details

I. General information

NPI: 1740211408
Provider Name (Legal Business Name): ASUQUO INYANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183RD STREET & 3RD AVENUE ST. BARNABAS ANES ASSOC
BRONX NY
10457
US

IV. Provider business mailing address

PO BOX 3048 ST. BARNABAS ANES ASSOC
BUFFALO NY
14240-3048
US

V. Phone/Fax

Practice location:
  • Phone: 718-960-6238
  • Fax: 718-960-3748
Mailing address:
  • Phone: 800-720-1664
  • Fax: 207-753-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number001334
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: