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General NPI Number Information
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NPI Number | 1730220708
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Entity Type | Individual
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Provider Name | DANSO OKOAMPA AGYEMAN B.SC, PAC
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Gender | Male
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Dates
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Enumeration Date | 02/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 506 MALCOLM X BLVD RM. 12119
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City | NEW YORK
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State | NY
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Zip | 10037-1802
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Country | US
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Telephone | 212-939-1648
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Fax | 212-939-1798
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Provider Business Mailing Address
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Address Line | 10 E 138TH ST APT.# 9B
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City | NEW YORK
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State | NY
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Zip | 10037-2001
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Country | US
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Telephone | 212-368-5580
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Fax | 212-368-5580
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 008907
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License Number State | NY
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