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NPI Code Detail

MEDICARE: DR. ASAMOAH OTENG PHARMD

MEDICARE: DR. ASAMOAH OTENG PHARMD
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
1183500000XPharmacistPCT0010618CT

General Provider Information

NPI Number : 1063949519
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ASAMOAH OTENG PHARMD
Provider Business Mailing Address
First Line : 479 BLUE HILLS AVE
Second Line :
City : HARTFORD
State : CT
Zip : 06112-1514
Country : US
Telephone Number : 860-769-6870
Fax Number :
Provider Business Practice Location Address
First Line : 479 BLUE HILLS AVE
Second Line :
City : HARTFORD
State : CT
Zip : 06112-1514
Country : US
Telephone Number : 860-769-6870
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2017
Last Update Date : 05/15/2017

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