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General NPI Number Information
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NPI Number | 1841391695
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Entity Type | Organization
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Legal Business Name | ELMONT MEDICAL PC
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 05/09/2008
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Provider Practice Location Address
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Address Line | 135 ROCKMART AVE
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City | ELMONT
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State | NY
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Zip | 11003-1731
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Country | US
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Telephone | 516-354-5600
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Fax | 516-354-1480
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Provider Business Mailing Address
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Address Line | PO BOX 30682
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City | ELMONT
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State | NY
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Zip | 11003-0682
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Country | US
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Telephone | 516-654-5600
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Fax | 516-354-1480
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. AKWASI AFRIYI ACHAMPONG
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Credential | DO
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Telephone | 516-354-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 216449
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License Number State | NY
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