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General NPI Number Information
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NPI Number | 1487567186
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Entity Type | Individual
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Provider Name | LAWRENCE OPPONG-KYEKYEKU
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Gender | Male
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Dates
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Enumeration Date | 09/24/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 110 MAYOR GIBSON BLVD APT 307
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City | NEWARK
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State | NJ
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Zip | 07104-3987
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Country | US
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Telephone | 910-745-2412
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Fax |
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Provider Business Mailing Address
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Address Line | 110 MAYOR GIBSON BLVD APT 307
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City | NEWARK
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State | NJ
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Zip | 07104-3987
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Country | US
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Telephone | 910-745-2412
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | F360432
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License Number State | NY
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