Provider Demographics
NPI:1134346901
Name:YAMUSAH, EMMANUEL NYABA (MD)
Entity type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:NYABA
Last Name:YAMUSAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:634 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514-1925
Mailing Address - Country:US
Mailing Address - Phone:973-279-2616
Mailing Address - Fax:973-279-0399
Practice Address - Street 1:634 BROADWAY
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1925
Practice Address - Country:US
Practice Address - Phone:973-279-2616
Practice Address - Fax:973-279-0399
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA48939207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine