Healthcare Provider Details

I. General information

NPI: 1265921662
Provider Name (Legal Business Name): FREMLIN A DEKYI JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: AKWASI DEKYI JR. AKWASI DEKYI

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 10/07/2026
Certification Date: 10/21/2025
Deactivation Date: 09/10/2026
Reactivation Date: 10/07/2026

III. Provider practice location address

1042 FLATBUSH AVE
BROOKLYN NY
11226-5428
US

IV. Provider business mailing address

9341 SPRINGFIELD BLVD
QUEENS VILLAGE NY
11428-1863
US

V. Phone/Fax

Practice location:
  • Phone: 917-428-8463
  • Fax:
Mailing address:
  • Phone: 315-415-3546
  • Fax: 804-415-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number306876
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number306876
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: