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NPI Code Detail

MEDICARE: MR. LUTHER O APPIAH PA-C

MEDICARE:  MR. LUTHER O APPIAH  PA-C
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
1363A00000XPhysician Assistant025592NY

General Provider Information

NPI Number : 1821610106
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LUTHER O APPIAH PA-C
Provider Business Mailing Address
First Line : 129 WALDRON AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10301-3618
Country : US
Telephone Number : 917-515-4185
Fax Number :
Provider Business Practice Location Address
First Line : 129 WALDRON AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10301-3618
Country : US
Telephone Number : 917-515-4185
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2020
Last Update Date : 11/24/2020

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Directions to “ MR. LUTHER O APPIAH PA-C” Practice Location

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