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General NPI Number Information
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NPI Number | 1174893754
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Entity Type | Individual
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Provider Name | NANA ACHEAMPONG R.N, ANP-C
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Gender | Female
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 05/29/2018
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Provider Practice Location Address
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Address Line | 3 DELAWARE DR
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City | NEW HYDE PARK
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State | NY
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Zip | 11042
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Country | US
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Telephone | 516-622-6105
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Fax |
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Provider Business Mailing Address
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Address Line | 263 WESTCHESTER AVE
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City | WEST BABYLON
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State | NY
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Zip | 11704-2116
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Country | US
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Telephone | 631-491-4529
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 650721
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | F3083891
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License Number State | NY
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