MEDICARE: KWAMINA AMONOO-NEIZER

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1891672580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KWAMINA AMONOO-NEIZER

Provider Business Mailing Address
First Line	:	1445 E WOODBURY RD
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91104-1555
Country	:	US
Telephone Number	:	312-388-4177
Fax Number	:

Provider Business Practice Location Address
First Line	:	1445 E WOODBURY RD
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91104-1555
Country	:	US
Telephone Number	:	312-388-4177
Fax Number	:

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

Provider Enumeration Date	:	08/16/2025
Last Update Date	:	08/25/2025

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Directions to “ KWAMINA AMONOO-NEIZER ” Practice Location

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