Healthcare Provider Details

I. General information

NPI: 1538506753
Provider Name (Legal Business Name): EKUA OWUSU-BEDIAKO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EKUA ABBAN M.D.

II. Dates (important events)

Enumeration Date: 05/29/2013
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 604
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-2141
  • Fax:
Mailing address:
  • Phone: 585-275-1385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD464359
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number324244
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: