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NPI Code Detail

MEDICARE: GRACE ASIAMAH-FRASER NP

MEDICARE: GRACE ASIAMAH-FRASER NP
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
1363LG0600XGerontology Nurse Practitioner340272NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1340272OTHERNYLIC #

General Provider Information

NPI Number : 1568531499
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE ASIAMAH-FRASER NP
Provider Business Mailing Address
First Line : 34 LUDWIG LN
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10303-2111
Country : US
Telephone Number : 718-963-8000
Fax Number : 718-630-3344
Provider Business Practice Location Address
First Line : 760 BROADWAY
Second Line :
City : BROOKLYN
State : NY
Zip : 11206
Country : US
Telephone Number : 718-963-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/08/2007

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