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General NPI Number Information
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NPI Number | 1275395352
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Entity Type | Individual
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Provider Name | BERNARD ANTWI FNP
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Gender | Male
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Dates
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Enumeration Date | 01/25/2024
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 838 FAIR ST
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City | CARMEL
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State | NY
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Zip | 10512-3085
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Country | US
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Telephone | 917-722-8839
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Fax |
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Provider Business Mailing Address
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Address Line | 28 YORKSHIRE DR
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City | SUFFERN
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State | NY
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Zip | 10901-7217
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Country | US
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Telephone | 646-492-0133
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2023126041
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License Number State | NJ
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