MEDICARE: DR. ADWOA GYAMFUA ESSUMAN M.D

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	212467-1	NY

General Provider Information

NPI Number	:	1861467938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADWOA GYAMFUA ESSUMAN M.D

Provider Business Mailing Address
First Line	:	8 NEW YORK AVE
Second Line	:
City	:	FREEPORT
State	:	NY
Zip	:	11520-2017
Country	:	US
Telephone Number	:	516-208-3215
Fax Number	:	516-485-2278

Provider Business Practice Location Address
First Line	:	451 UNIONDALE AVE
Second Line	:
City	:	UNIONDALE
State	:	NY
Zip	:	11553-2232
Country	:	US
Telephone Number	:	516-485-2277
Fax Number	:	516-485-2229

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	07/08/2007

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