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General NPI Number Information
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NPI Number | 1801616826
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Entity Type | Individual
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Provider Name | EMMANUEL YEBOAH APN, FNP
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Gender | Male
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 400 WESTFIELD AVE
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City | ELIZABETH
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State | NJ
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Zip | 07208-1621
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Country | US
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Telephone | 908-677-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 16 KOSTER BLVD APT 4B
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City | EDISON
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State | NJ
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Zip | 08837-4233
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Country | US
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Telephone | 862-367-2879
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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 | 26NJ15189500
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License Number State | NJ
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