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General NPI Number Information
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NPI Number | 1023849254
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Entity Type | Organization
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Legal Business Name | PEACE HEALTHCARE SERVICES NURSE PRACTITIONER IN FAMILY HEALTH PLLC
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Dates
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Enumeration Date | 08/09/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 12 MAGNOLIA DR
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City | WAPPINGERS FALLS
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State | NY
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Zip | 12590-7045
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Country | US
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Telephone | 718-200-4339
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Fax |
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Provider Business Mailing Address
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Address Line | 12 MAGNOLIA DR
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City | WAPPINGERS FALLS
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State | NY
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Zip | 12590-7045
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Country | US
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Telephone | 718-200-4339
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Fax |
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Authorized Official
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Title or Position | DNP FNP-BC
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Name | DR. ALEXANDER ABOAGYE ADUAMAH
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Credential | DNP, RN MSN, FNP-BC
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Telephone | 718-200-4339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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