MEDICARE: EKUA ANSAH-SAMUELS MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula

General Provider Information

NPI Number	:	1023801941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EKUA ANSAH-SAMUELS MPH

Provider Business Mailing Address
First Line	:	4060 MURDOCK AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2323
Country	:	US
Telephone Number	:	646-410-6020
Fax Number	:	646-410-6020

Provider Business Practice Location Address
First Line	:	4060 MURDOCK AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2323
Country	:	US
Telephone Number	:	646-410-6020
Fax Number	:	646-410-6020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2025
Last Update Date	:	05/23/2025

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