Healthcare Provider Details

I. General information

NPI: 1083935399
Provider Name (Legal Business Name): PETER APEAKORANG PHYSICIAN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 06/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1763 ROCKAWAY PKWY
BROOKLYN NY
11236-5000
US

IV. Provider business mailing address

PO BOX 360336
BROOKLYN NY
11236-0336
US

V. Phone/Fax

Practice location:
  • Phone: 718-209-3940
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number187004
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number187004
License Number StateNY

VIII. Authorized Official

Name: DR. PETER APEAKORANG
Title or Position: PRESIDENT
Credential: PHYSICIAN
Phone: 718-209-3940