Healthcare Provider Details

I. General information

NPI: 1861467938
Provider Name (Legal Business Name): ADWOA GYAMFUA ESSUMAN M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 UNIONDALE AVE
UNIONDALE NY
11553-2232
US

IV. Provider business mailing address

8 NEW YORK AVE
FREEPORT NY
11520-2017
US

V. Phone/Fax

Practice location:
  • Phone: 516-485-2277
  • Fax: 516-485-2229
Mailing address:
  • Phone: 516-208-3215
  • Fax: 516-485-2278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number212467-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: