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General NPI Number Information
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NPI Number | 1174037766
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Entity Type | Individual
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Provider Name | ABENA AMO-BADU
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Gender | Female
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Dates
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Enumeration Date | 11/19/2017
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 302 ROUTE 25A
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City | MILLER PLACE
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State | NY
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Zip | 11764-2413
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Country | US
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Telephone | 631-331-3162
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Fax | 631-331-2795
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Provider Business Mailing Address
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Address Line | 2 HEATHER CT
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City | HOLTSVILLE
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State | NY
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Zip | 11742-2521
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Country | US
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Telephone | 631-860-8359
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PR46971
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License Number State | ME
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