Healthcare Provider Details

I. General information

NPI: 1013473255
Provider Name (Legal Business Name): FRANK KWABENA YEBOAH LNHA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2019
Last Update Date: 02/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NEW TURNPIKE RD
TROY NY
12182-1412
US

IV. Provider business mailing address

8 ROSEBUD CT
RENSSELAER NY
12144-5620
US

V. Phone/Fax

Practice location:
  • Phone: 518-235-1410
  • Fax: 518-235-1632
Mailing address:
  • Phone: 518-506-1924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License NumberNH5488
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number3143
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number05809
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: