Healthcare Provider Details

I. General information

NPI: 1205418803
Provider Name (Legal Business Name): JUDE APPIAH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 REMSEN ST
BROOKLYN NY
11201-4333
US

IV. Provider business mailing address

1 RESEARCH RD
RIDGE NY
11961-2701
US

V. Phone/Fax

Practice location:
  • Phone: 855-528-7322
  • Fax:
Mailing address:
  • Phone: 631-751-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number342129
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: