Healthcare Provider Details

I. General information

NPI: 1760801948
Provider Name (Legal Business Name): AFUA ASANTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 06/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E 17TH ST
NEW YORK NY
10003
US

IV. Provider business mailing address

301 E 17TH ST
NEW YORK NY
10003-3804
US

V. Phone/Fax

Practice location:
  • Phone: 212-598-7671
  • Fax:
Mailing address:
  • Phone: 212-598-7671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number293191
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: