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NPI Code Detail

MEDICARE: SAMUEL BOATENG AKUOKU M.D

MEDICARE: SAMUEL BOATENG AKUOKU 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
1207R00000XInternal Medicine Physician178587NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962574418
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL BOATENG AKUOKU M.D
Provider Business Mailing Address
First Line : 8 TATEM WAY
Second Line :
City : OLD WESTBURY
State : NY
Zip : 11568-1716
Country : US
Telephone Number : 718-344-8207
Fax Number : 718-949-0331
Provider Business Practice Location Address
First Line : 22414 MERRICK BLVD
Second Line :
City : LAURELTON
State : NY
Zip : 11413-2023
Country : US
Telephone Number : 718-949-6433
Fax Number : 718-949-0331
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 02/11/2021

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