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General NPI Number Information
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NPI Number | 1538640420
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Entity Type | Individual
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Provider Name | ISAAC OKYERE AMPOFO
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Gender | Male
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Dates
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Enumeration Date | 08/28/2018
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Last Update Date | 01/14/2020
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Provider Practice Location Address
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Address Line | 629 MIDDLE TURNPIKE EAST
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City | MANCHESTER
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State | CT
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Zip | 06040-3571
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Country | US
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Telephone | 860-649-6900
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Fax | 860-647-0469
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Provider Business Mailing Address
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Address Line | 629 MIDDLE TURNPIKE EAST
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City | MANCHESTER
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State | CT
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Zip | 06040-3731
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Country | US
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Telephone | 860-649-6900
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Fax | 860-647-0469
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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 | F08180668
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License Number State | CT
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