Healthcare Provider Details

I. General information

NPI: 1205019502
Provider Name (Legal Business Name): YIADOM KWADWO BOAKYE-DANQUAH PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 S COLUMBUS AVE
MOUNT VERNON NY
10553-1919
US

IV. Provider business mailing address

324 S COLUMBUS AVE
MOUNT VERNON NY
10553-1919
US

V. Phone/Fax

Practice location:
  • Phone: 914-297-2557
  • Fax: 914-297-2937
Mailing address:
  • Phone: 914-297-2557
  • Fax: 914-297-2937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number050621
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: